Individual
JAN L. ROTH-HAUPTMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
305 E 24TH ST, APT. 6C, NEW YORK, NY 10010-4011
(212) 686-5116
Mailing address
305 E 24TH ST, APT. 6C, NEW YORK, NY 10010-4011
(212) 686-5116
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009624
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01257996
—
NY
Enumeration date
03/18/2006
Last updated
07/08/2007
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