Organization · Type 2 NPI
Jennica Laine-Formisano Psyd
Mental Health Clinic/Center (Including Community Mental Health Center) · Kingston, NY
NPI number
1093454159
Active
Practice location
260 Kings Mall Ct # 331
Kingston, NY 12401-1574
Fax (845) 332-6041
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
Another provider at this address
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About NPI 1093454159
Jennica Laine-Formisano Psyd's National Provider Identifier is 1093454159, issued on May 27, 2022. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Kingston, NY. The record was last updated on May 27, 2022.