Provider Demographics
NPI:1164724530
Name:SIMON-O'BRIEN, LAURA YVONNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:YVONNE
Last Name:SIMON-O'BRIEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 KNOLLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1833
Mailing Address - Country:US
Mailing Address - Phone:914-686-6891
Mailing Address - Fax:914-682-7518
Practice Address - Street 1:297 KNOLLWOOD RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1833
Practice Address - Country:US
Practice Address - Phone:914-686-6891
Practice Address - Fax:914-682-7518
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013089-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist