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Organization

WAVELENGTHS PSYCHOLOGY, PC

Active
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Organization

WAVELENGTHS PSYCHOLOGY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHARON GRAND PHD (OWNER)
(800) 871-5491
Entity
Organization

Contact information

Practice address
4770 SUNRISE HWY, SUITE 105, MASSAPEQUA PARK, NY 11762-2911
(800) 871-5491
(800) 871-5491
Mailing address
4770 SUNRISE HWY, SUITE 105, MASSAPEQUA PARK, NY 11762-2911
(800) 871-5491
(800) 871-5491

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
02/05/2016
Last updated
12/12/2016
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