Individual
LAUREN GREY OUTLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1865 AMSTERDAM AVE, NEW YORK, NY 10031-1716
(212) 234-2653
Mailing address
11240 177TH ST, ADDISLEIGH PARK, NY 11433-4114
(516) 455-8668
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
091564-1
NY
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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