Individual
LISA TEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
111 E 210TH ST FL C2, BRONX, NY 10467-2401
(718) 920-6337
Mailing address
111 E 210TH ST FL C2, BRONX, NY 10467-2401
(718) 920-6337
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00888239
—
NY
Enumeration date
08/18/2010
Last updated
07/14/2022
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