Individual
DR. JACLYN LOPEZ WITMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
67 IRVING PL FL 6, NEW YORK, NY 10003-2237
(908) 403-8906
Mailing address
67 IRVING PL FL 6, NEW YORK, NY 10003-2237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
022762
NY
103T00000X
Psychologist
022762
NY
103TC0700X
Clinical Psychologist
Primary
022762
NY
103TC0700X
Clinical Psychologist
PSY1001268
DC
Other
Enumeration date
09/15/2017
Last updated
01/31/2023
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