Individual
BAILEY ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
605 W 112TH ST, NEW YORK, NY 10025-1836
(202) 427-3974
Mailing address
605 W 112TH ST, NEW YORK, NY 10025-1836
(202) 427-3974
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
68011195
NY
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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