Individual
MRS. CAROL S THEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
151 E 80TH ST, 1A, NEW YORK, NY 10021-0442
(212) 861-3308
(212) 517-9323
Mailing address
151 E 80TH ST, 1A, NEW YORK, NY 10021-0442
(212) 861-3308
(212) 517-9323
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
RO21850
NY
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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