Individual
MAXINE L GANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1199 PARK AVE APT 1K, NEW YORK, NY 10128-1713
(212) 860-3368
Mailing address
1199 PARK AVE APT 1K, NEW YORK, NY 10128-1713
(212) 860-3368
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6675
CA
103TC0700X
Clinical Psychologist
Primary
7966
NY
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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