Individual
JEPHTHA TAUSIG-EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
295 CENTRAL PARK W, SUITE 2, OFFICE 1, NEW YORK, NY 10024-3008
(212) 595-9348
Mailing address
295 CENTRAL PARK W, SUITE 2, OFFICE 1, NEW YORK, NY 10024-3008
(212) 595-9348
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
68-016753
NY
103TC0700X
Clinical Psychologist
Primary
68-016753
NY
Other
Enumeration date
01/25/2007
Last updated
09/26/2007
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