| NPI | 1033352778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA LOURDES GONZALES Licensed Clinical Psychologist 212-579-7666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 015211-1) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 015211-1) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 015211-1) | |
| 103TF0000X Psychologist, Family (Licence: NY 015211-1) | |
| 103TH0004X Psychologist, Health (Licence: NY 015211-1) | |
| 103TH0100X Psychologist, Health Service (Licence: NY 015211-1) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NY 015211-1) | |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2009-04-10 |