Individual
AMANDA DIANA PERSAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4628 VERNON BLVD STE 103, LONG ISLAND CITY, NY 11101-5352
(914) 494-2936
Mailing address
4628 VERNON BLVD STE 103, LONG ISLAND CITY, NY 11101-5352
(646) 902-4792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
026204
NY
Other
Enumeration date
12/08/2023
Last updated
11/19/2024
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