Individual
DR. LISA K PASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH. D.
Contact information
Practice address
240 W 102ND ST, SUITE 15, NEW YORK, NY 10025-4900
(917) 974-9150
Mailing address
2 E END AVE, APT 2A, NEW YORK, NY 10075-1192
(917) 974-9150
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
009732
NY
103TS0200X
School Psychologist
Primary
009732
NY
Other
Enumeration date
04/09/2007
Last updated
05/23/2013
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