Individual
MELISSA ANGELA VIVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
915 W END AVE, APT 6F, NEW YORK, NY 10025-3535
(516) 521-3940
Mailing address
915 W END AVE, APT 6F, NEW YORK, NY 10025-3535
(516) 521-3940
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
012964
NY
Other
Enumeration date
04/28/2009
Last updated
08/06/2014
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