Individual
DR. RANDI E WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1235 PARK AVE, SUITE 4C, NEW YORK, NY 10128-1759
(212) 722-6838
Mailing address
1235 PARK AVE, SUITE 4C, NEW YORK, NY 10128-1759
(212) 722-6838
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
011327-1
NY
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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