Individual
DR. EARTHA M HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13037 235TH ST, ROSEDALE, NY 11422-1215
(646) 209-3753
Mailing address
13037 235TH ST, ROSEDALE, NY 11422-1215
(646) 209-3753
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
024082-01
NY
Other
Enumeration date
04/26/2021
Last updated
04/26/2021
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