Individual
IVELISSE DYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
5030 BROADWAY, NEW YORK, NY 10034-1609
(646) 470-0639
Mailing address
5030 BROADWAY, NEW YORK, NY 10034-1609
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Enumeration date
06/08/2026
Last updated
06/08/2026
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