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Individual

CAROLYN DE LA MATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 W 43RD ST APT 16T, NEW YORK, NY 10036-6307
(914) 620-2214
Mailing address
400 W 43RD ST APT 16T, NEW YORK, NY 10036-6307

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
013384
NY
106S00000X
Behavior Technician

Other

Enumeration date
04/01/2019
Last updated
04/18/2023
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