Individual
MAHDIYA FAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
465 GRAND ST, NEW YORK, NY 10002-4800
(212) 420-1970
Mailing address
8025 PARSONS BLVD APT A23, JAMAICA, NY 11432-1039
(407) 227-3889
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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