LAWRENCE FANTL

BRONX, NY
NPI1619578887
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: NY  7556)
Enumeration Date2020-11-04
Last Update Date2020-11-04
Business Address
LAWRENCE FANTL
529 COURTLANDT AVE
BRONX, NY 10451-5007
Phone number: 718-993-7700
Mailing Address
LAWRENCE FANTL
529 COURTLANDT AVE
BRONX, NY 10451-5007
Phone number: