Organization
MADDIX THERAPY ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIESHA MADDIX PSYD (PSYCHOLOGIST)
(917) 667-0462
Entity
Organization
Contact information
Practice address
595 E 59TH ST, BROOKLYN, NY 11234-1301
(718) 864-1135
Mailing address
2909 PARK AVE, BRIDGEPORT, CT 06604-1328
(917) 667-0462
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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