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General NPI Number Information
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NPI Number | 1457634354
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Entity Type | Individual
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Provider Name | MARIAN RISSENBERG PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 03/04/2016
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Provider Practice Location Address
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Address Line | 125 KATONAH AVE
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City | KATONAH
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State | NY
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Zip | 10536-2136
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Country | US
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Telephone | 914-232-6245
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Fax | 914-232-6245
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Provider Business Mailing Address
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Address Line | 125 KATONAH AVE
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City | KATONAH
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State | NY
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Zip | 10536-2136
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Country | US
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Telephone | 914-232-6245
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Fax | 914-232-6245
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 009016
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 009016
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 009016
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License Number State | NY
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