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General NPI Number Information
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NPI Number | 1386044923
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Entity Type | Individual
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Provider Name | RACHEL ANNE GARDNER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 591 STATE ROUTE 244
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City | ALFRED STATION
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State | NY
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Zip | 14803-1580
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Country | US
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Telephone | 585-204-7560
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Fax | 585-206-4903
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Provider Business Mailing Address
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Address Line | 5268 LANDIS RD
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City | HORNELL
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State | NY
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Zip | 14843-9026
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Country | US
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Telephone | 585-204-7560
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 022851-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 56332
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License Number State |
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