Provider Demographics
NPI:1932762044
Name:MARKIN DEY, THERESA (PSYD)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:MARKIN DEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:DEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6739 FALCONS PT
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9806
Mailing Address - Country:US
Mailing Address - Phone:585-797-4874
Mailing Address - Fax:
Practice Address - Street 1:3019 COUNTY COMPLEX DR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9505
Practice Address - Country:US
Practice Address - Phone:585-396-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022593103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist