Individual
LANEY ELIZABETH WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPS, LCAT, ATR-BC
Contact information
Practice address
515 MADISON AVE FL 21, NEW YORK, NY 10022-5433
(515) 577-6281
Mailing address
300 COLES ST APT 506, JERSEY CITY, NJ 07310-1046
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
002041
NY
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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