Individual
JACQUELINE CARSTEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1 PARK AVE, NEW YORK, NY 10016-5802
(646) 754-5000
Mailing address
1 PARK AVE, NEW YORK, NY 10016-5802
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
025098
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/26/2021
Last updated
04/25/2023
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