Provider Demographics
NPI:1285888560
Name:INESON, PATTY A (MS)
Entity type:Individual
Prefix:MRS
First Name:PATTY
Middle Name:A
Last Name:INESON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TOR RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4625
Mailing Address - Country:US
Mailing Address - Phone:845-297-8063
Mailing Address - Fax:845-297-1535
Practice Address - Street 1:12 TOR RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4625
Practice Address - Country:US
Practice Address - Phone:845-297-8063
Practice Address - Fax:845-297-1535
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101Y00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor