Waldbaum, Jewell K
Waldbaum, Jewell K is an sole proprietor health care provider with primary practice located at 12 Hawk St , Spring Valley NY 10977-6104. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Waldbaum, Jewell K can be contacted via phone (845) 356-6329.Contact Information
Primary practice address
12 Hawk St
Spring Valley NY 10977-6104
Phone: (845) 356-6329
Fax: (845) 425-0144
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 3934 | New York |
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 3934 | New York |
Behavioral Health & Social Service Providers / Health Service | 103TH0100X | 3934 | New York |
Profile Details
NPI number | 1124024005 |
---|---|
LBN Legal business name | Waldbaum, Jewell K |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 24th, 2005 |
Last updated | Dec 9th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1124024005 | NPPES |
Other | 0081767 | GHI IDENTIFICATION NUMBER | |
Other | 3934 | GHI IDENTIFICATION NUMBER |
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