Individual
IRENA ILIEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
425 E 61ST ST, PH FLOOR, NEW YORK, NY 10065-8722
(617) 515-7645
Mailing address
425 E 61ST ST, PH FLOOR, NEW YORK, NY 10065-8722
(617) 515-7645
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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