Garris-Shade, Julissa

Garris-Shade, Julissa is an sole proprietor health care provider with primary practice located at 222 Bagatelle Rd , Melville NY 11747-4104. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Garris-Shade, Julissa can be contacted via phone (631) 643-6960.

Contact Information

Primary practice address
222 Bagatelle Rd Melville NY 11747-4104
Phone: (631) 643-6960
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1740722313
LBN Legal business name Garris-Shade, Julissa
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2016
Last updated Nov 13th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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