Individual
LISA BRODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6851 GROTON ST, FOREST HILLS, NY 11375-5155
(917) 407-9609
Mailing address
6851 GROTON ST, FOREST HILLS, NY 11375-5155
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
01147
NY
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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