Individual
MS. ANGINESE DAVINE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCAT, BC-DMT
Contact information
Practice address
280 MADISON AVE RM 608, NEW YORK, NY 10016-0800
(646) 389-5801
Mailing address
115 E 122ND ST APT 5A, NEW YORK, NY 10035-2824
(917) 574-1185
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
—
—
225600000X
Dance Therapist
Primary
001952
NY
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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