Organization
MOSAIC PSYCHOLOGICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE BRYANT TUCKETT PHD (PRESIDENT OWNER)
(914) 764-4413
Entity
Organization
Contact information
Practice address
23 OLD SNAKE HILL ROAD, POUND RIDGE, NY 10576-2101
(914) 764-4413
Mailing address
23 OLD SNAKE HILL ROAD, POUND RIDGE, NY 10576-2101
(914) 764-4413
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01727471
—
NY
Enumeration date
01/26/2007
Last updated
11/11/2010
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