Individual
ALEXANDRA KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
41 UNION SQ W STE 1328, NEW YORK, NY 10003-3252
(347) 670-3774
Mailing address
404 E 79TH ST APT 4F, NEW YORK, NY 10075-1481
(917) 763-6593
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
002522
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2017
Last updated
09/16/2021
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