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Individual

DR. RICHARD WERTH SHOUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MFT

Contact information

Practice address
10 E END AVE, 16A, NEW YORK, NY 10075-1106
(212) 628-1812
Mailing address
10 E END AVE, 16A, NEW YORK, NY 10075-1106
(212) 628-1812

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000188
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MFT000188
MFT
NY
Enumeration date
10/15/2008
Last updated
10/15/2008
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