Individual
DR. DANIELLE MITNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 SHELBOURNE LN, COMMACK, NY 11725-2613
(516) 395-7677
Mailing address
21 SHELBOURNE LN, COMMACK, NY 11725-2613
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
024050-01
NY
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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