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Organization
PSYCHOTHERAPY AND MENTAL WELLNESS GROUP PRACTICE, PLLC
Active
Organization
PSYCHOTHERAPY AND MENTAL WELLNESS GROUP PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA BOUDIN PSY.D. (LICENSED PSYCHOLOGIST/CLINICAL DIR)
(213) 373-4484
Entity
Organization
Contact information
Practice address
10 SAINT PAULS PL APT 1L, BROOKLYN, NY 11226-1363
(213) 373-4484
Mailing address
10 SAINT PAULS PL APT 1L, BROOKLYN, NY 11226-1363
(213) 373-4484
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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