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Individual

DR. MARY ELIZABETH BRADDOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
19 E 98TH ST, NEW YORK, NY 10029-6501
(201) 240-5538
Mailing address
2611 FREDERICK DOUGLASS BLVD APT 4E, NEW YORK, NY 10030-3498
(201) 240-5538

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
024102
NY

Other

Enumeration date
06/18/2021
Last updated
06/28/2021
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