Individual
JESSICA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
303 5TH AVE, SUITE 1107, NEW YORK, NY 10016-6601
(929) 274-0580
Mailing address
311 E 11TH ST, APT. 1A, NEW YORK, NY 10003-7479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021823
NY
Other
Enumeration date
02/23/2016
Last updated
10/15/2016
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