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General NPI Number Information
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NPI Number | 1831400712
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Entity Type | Individual
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Provider Name | LAURA E. BRESLER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 7503 N BROADWAY
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City | RED HOOK
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State | NY
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Zip | 12571-1463
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Country | US
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Telephone | 845-514-4626
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Fax |
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Provider Business Mailing Address
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Address Line | 43 WYNKOOP LN
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City | RHINEBECK
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State | NY
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Zip | 12572-1509
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Country | US
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Telephone | 845-514-4626
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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 | 017689-1
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License Number State | NY
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