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General NPI Number Information
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NPI Number | 1659395929
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Entity Type | Individual
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Provider Name | JEANNE M. DEVINE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 12/13/2018
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Provider Practice Location Address
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Address Line | 156 W 56TH ST STE 1804
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City | NEW YORK
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State | NY
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Zip | 10019-3878
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Country | US
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Telephone | 212-851-8100
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Fax | 888-977-2547
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Provider Business Mailing Address
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Address Line | 25-114 BARKER ST
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City | MOUNT KISCO
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State | NY
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Zip | 10549-1648
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Country | US
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Telephone | 914-420-2395
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 13007
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License Number State | NY
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