Individual
LARISSA PORTNOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37 W 20TH ST, NEW YORK, NY 10011-3706
(212) 256-1659
Mailing address
37 W 20TH ST, NEW YORK, NY 10011-3706
(212) 256-1659
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
110582-01
NY
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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