Provider Demographics
NPI:1598406837
Name:CAMBRIA, ANTOINETTE MARY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTOINETTE
Middle Name:MARY
Last Name:CAMBRIA
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:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:DANNEMORA
Mailing Address - State:NY
Mailing Address - Zip Code:12929-0608
Mailing Address - Country:US
Mailing Address - Phone:717-343-2948
Mailing Address - Fax:
Practice Address - Street 1:101 BROAD ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2637
Practice Address - Country:US
Practice Address - Phone:518-564-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health