institution
Jennica Laine-formisano Psyd
Mental Health Clinic/Center (Including Community Mental Health Center) in Kingston, New York
NPI 1093454159

Jennica Laine-formisano Psyd is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Kingston, NY and is specialized in Mental Health (Including Community Mental Health Center). Jennica Laine-formisano Psyd practices in Kingston, NY. The NPI Number for Jennica Laine-formisano Psyd is 1093454159 and holds a License No. (New York).

The current practice location address for Jennica Laine-formisano Psyd is 260 Kings Mall Ct # 331, Kingston, NY and can be reached out via phone at 845-489-3687 and via fax at 845-332-6041.

Location: 260 Kings Mall Ct # 331, Kingston, NY, 12401-1574
institution
Provider Profile Details
NPI Number
1093454159
Provider Name
Jennica Laine-formisano Psyd
Credential
Provider Entity Type
Organization
Address
260 Kings Mall Ct # 331, Kingston, NY, 12401-1574
Phone Number
845-489-3687
Fax Number
845-332-6041
Provider Enumeration Date
05/27/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
260 Kings Mall Ct # 331
City
State
Zip
12401-1574
Phone Number
845-489-3687
Fax Number
845-332-6041
person
Provider Business Mailing Address Details
Address
260 Kings Mall Ct # 331
City
State
Zip
12401-1574
Phone Number
845-489-3687
Fax Number
845-332-6041
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
()
Definition
Definition to come...
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