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General NPI Number Information
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NPI Number | 1689692816
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Entity Type | Individual
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Provider Name | DONNA RASIN-WATERS PHD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 38 8TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11217-3907
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Country | US
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Telephone | 718-623-6291
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Fax |
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Provider Business Mailing Address
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Address Line | 71 MIDWOOD ST
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City | BROOKLYN
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State | NY
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Zip | 11225-5003
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Country | US
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Telephone | 718-284-7407
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Fax | 718-284-4468
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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 | 011164
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License Number State | NY
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