Provider Demographics
NPI:1043631641
Name:MURPHY, THERESA NONA
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:NONA
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ROCKLEDGE RD APT TB
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10708-5327
Mailing Address - Country:US
Mailing Address - Phone:914-961-3828
Mailing Address - Fax:
Practice Address - Street 1:63 ROCKLEDGE RD APT TB
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10708-5327
Practice Address - Country:US
Practice Address - Phone:914-961-3828
Practice Address - Fax:914-961-3828
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR018070-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health