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Organization
WAYNE LAVENDER PHD
Active
Organization
WAYNE LAVENDER PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE J LAVENDER PHD (OWNER)
(718) 596-7442
Entity
Organization
Contact information
Practice address
62 PIERREPONT ST, # 1E, BROOKLYN, NY 11201-2452
(718) 596-7442
Mailing address
62 PIERREPONT ST, # 1E, BROOKLYN, NY 11201-2452
(718) 596-7442
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4755
NY
Other
Enumeration date
06/21/2007
Last updated
08/22/2020
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