Provider Demographics
NPI:1558579383
Name:DEVEAUX, FAITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:
Last Name:DEVEAUX
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 CANNON PL
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-4301
Mailing Address - Country:US
Mailing Address - Phone:718-884-0068
Mailing Address - Fax:
Practice Address - Street 1:1 ELM ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:TUCKAHOE
Practice Address - State:NY
Practice Address - Zip Code:10707-3925
Practice Address - Country:US
Practice Address - Phone:914-961-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10004103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist