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General NPI Number Information
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NPI Number | 1457539041
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Entity Type | Organization
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Legal Business Name | TRAUMA AND ADDICTIONS RECOVERY ASSOC.
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 801 BEDFORD RD
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City | SCHENECTADY
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State | NY
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Zip | 12308-3407
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Country | US
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Telephone | 518-395-9187
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Fax | 518-346-0292
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Provider Business Mailing Address
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Address Line | 801 BEDFORD RD
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City | SCHENECTADY
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State | NY
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Zip | 12308-3407
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Country | US
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Telephone | 518-395-9187
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Fax | 518-346-0292
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. ROSEMARIE DOROTHEA AMENDOLIA
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Credential | PHD
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Telephone | 518-395-9187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 011270
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License Number State | NY
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