Port City Psychotherapy and Psychological Services

NPI #1598931578 in Oswego, New York

Provider Information

NPI Number: 1598931578
Entity Type: Organization
Organization Name: Port City Psychotherapy and Psychological Services
Primary Specialty: Psychologist - Clinical
Enumeration Date: Apr 30, 2008
Last Updated: Apr 30, 2008

Practice Location

Address: 46 E ONEIDA ST
City: Oswego
State: New York
ZIP Code: 13126-2218
Phone: (315) 342-2558

Authorized Official

Name: DR. BROOKS B GUMP, PHD
Title: VICE PRESIDENT
Phone: (315) 342-2558

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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