Provider Demographics
NPI:1356948749
Name:BURROWS, BETHANY (PSYD)
Entity type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:
Last Name:BURROWS
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 1:95 S KENSICO AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-2135
Mailing Address - Country:US
Mailing Address - Phone:734-904-1199
Mailing Address - Fax:
Practice Address - Street 1:311 BROADFIELD RD
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-2411
Practice Address - Country:US
Practice Address - Phone:914-576-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020654103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist