Basic Information
| Provider Information | |||||||||
| NPI: | 1588802854 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCDONALD | ||||||||
| FirstName: | JUDITH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9828 ROUTE 9 | ||||||||
| Address2: | |||||||||
| City: | CHAZY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188467040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 427 MARGARET ST | ||||||||
| Address2: | |||||||||
| City: | PLATTSBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 129011707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185613803 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | NY | Y | Behavioral Health & Social Service Providers | Psychologist | School |
No ID Information.