Individual
KRISTA L GWON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(617) 312-5257
Mailing address
500 W 56TH ST, APT 1802, NEW YORK, NY 10019-3583
(617) 312-5257
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
018208
NY
Other
Enumeration date
01/26/2007
Last updated
05/01/2014
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