Individual
CHELSEA STACK JEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
7901 BROADWAY OFC 11-113, ELMHURST, NY 11373-1329
(718) 334-2599
Mailing address
14 LYDIA DR, GUTTENBERG, NJ 07093-8301
(909) 455-4551
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P116700
NY
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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