Individual
MS. RACHEL STEPHANIE LACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.M.
Contact information
Practice address
57 W 57TH ST, SUITE 1007, NEW YORK, NY 10019-2802
(212) 658-0110
(646) 219-4619
Mailing address
57 W 57TH ST, SUITE 1007, NEW YORK, NY 10019-2802
(212) 658-0110
(646) 219-4619
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
04/20/2017
Last updated
04/21/2017
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