Individual
TAKIYAH RENEA WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 E 115TH ST, NEW YORK, NY 10029-1186
(212) 633-9300
Mailing address
590 AVENUE OF THE AMERICAS, NEW YORK, NY 10011-2022
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NY
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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