Individual
JILLEN B. AXELROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
96 5TH AVE APT 1D, NEW YORK, NY 10011-7604
(212) 505-1963
Mailing address
96 5TH AVE APT 1D, NEW YORK, NY 10011-7604
(212) 505-1963
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
006539
NY
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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