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Organization
MIRIELLE THERAPY PRACTICE, PLLC
Active
Organization
MIRIELLE THERAPY PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICE SHEPARD PHD (DIRECTOR)
(212) 545-9901
Entity
Organization
Contact information
Practice address
303 5TH AVE, SUITE 1909, NEW YORK, NY 10016-6601
(212) 545-9901
Mailing address
303 5TH AVE, SUITE 1909, NEW YORK, NY 10016-6601
(212) 545-9901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
018801-1
NY
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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