Provider Demographics
NPI:1285763474
Name:GUYETT, LORNA JEAN (PHD)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:JEAN
Last Name:GUYETT
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 1:61 GREEN MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-1838
Mailing Address - Country:US
Mailing Address - Phone:518-276-6479
Mailing Address - Fax:518-276-6642
Practice Address - Street 1:110 8TH ST
Practice Address - Street 2:RENSSELAER POLYTECHNIC INSTITUTE -COUNSELING CENTER
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-3522
Practice Address - Country:US
Practice Address - Phone:518-276-6479
Practice Address - Fax:518-276-6642
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013112-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist