JENNICA LAINE-FORMISANO

KINGSTON, NY
NPI1346587862
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: NY  021267-1)
Enumeration Date2013-01-04
Last Update Date2021-05-07
Business Address
Dr. JENNICA LAINE-FORMISANO Psy.D.
260 KINGS MALL CT # 331
KINGSTON, NY 12401-1574
Phone number: 845-489-3687
Mailing Address
Dr. JENNICA LAINE-FORMISANO Psy.D.
148 BURT ST
SAUGERTIES, NY 12477-1907
Phone number: 845-489-3687
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