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General NPI Number Information
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NPI Number | 1851802292
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL SERVICES OF WNY PLLC
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/05/2024
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Provider Practice Location Address
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Address Line | 84 LAKE ST
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City | HAMBURG
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State | NY
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Zip | 14075-4834
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Country | US
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Telephone | 716-422-0054
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Fax |
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Provider Business Mailing Address
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Address Line | 84 LAKE ST
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City | HAMBURG
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State | NY
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Zip | 14075-4834
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Country | US
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Telephone | 716-422-0054
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. KIMBERLY DIANE FRANKLIN
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Credential | PHD
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Telephone | 716-422-0054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 022061
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License Number State | NY
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