Individual
MARYAM OMIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 W 114TH ST, NEW YORK, NY 10025-1710
(212) 523-6489
Mailing address
158 WEST 124TH STREET, FLOOR 7, ROOM 721, NEW YORK, NY 10027
(332) 243-0075
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
025893
NY
Other
Enumeration date
09/12/2022
Last updated
11/06/2023
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