Individual
CHARITY K WIJETUNGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
240 CENTRAL PARK S APT 8C, NEW YORK, NY 10019-1453
(443) 286-9743
Mailing address
240 CENTRAL PARK S APT 8C, NEW YORK, NY 10019-1453
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P106439
NY
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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