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Individual

DR. JILL THISTLETHWAITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
156 5TH AVE, SUITE 720, NEW YORK, NY 10010-7002
(212) 337-9596
Mailing address
144 E 7TH ST, APT. C-12, NEW YORK, NY 10009-6203
(212) 982-5247

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
007451
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01132934
NY
Enumeration date
12/26/2006
Last updated
07/09/2007
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