Individual
LAURA D'NELL EIDLITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
286 5TH AVE, 6K, NEW YORK, NY 10001
(646) 460-2372
Mailing address
286 5TH AVE # 7K, NEW YORK, NY 10001-4512
(646) 460-2372
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
18 0004308
NY
101YM0800X
Mental Health Counselor
18004305
NY
103T00000X
Psychologist
Primary
023268
NY
103TC0700X
Clinical Psychologist
P08602
NY
Other
Enumeration date
09/10/2009
Last updated
07/10/2019
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