Willis T Van Dyne PSY D

NPI 1023123767 - Psychologist - 103TC0700X

NPI Details
NPI 1023123767
Gender Male
Enumeration Date 08/21/2006
Last Updated 04/15/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
41 2ND ST
TROY NY, 12180-3928, US
Phone (518) 272-0506
Fax
Business Location
41 2ND ST
TROY NY, 12180-3928, US
Phone (518) 272-0506
Fax
Toxanomy
Taxonomy Code 103TC0700X
License State New York
License Number 006790
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According to our database, Dr. Willis T Van Dyne PSY D NPI is 1023123767, taxonomy code is 103TC0700X and license number is 006790, license state is located at New York. Willis T Van Dyne PSY D physically located at 41 2nd St, Troy NY, 12180-3928. NPI Number Willis T Van Dyne PSY D has the Individual type.

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1023123767 NPI number is provided on an as is basis without warranty of any kind. 1023123767 is maintained by the National Plan & Provider Enumeration System. The contents of Willis T Van Dyne PSY D are for informational purposes only.