Individual
DR. JODI N. LICHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
25517 NORTHERN BLVD, SUITE 2B, LITTLE NECK, NY 11362-1453
(917) 364-8585
Mailing address
24008 65TH AVE, DOUGLASTON, NY 11362-1921
(917) 364-8585
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
016200
NY
Other
Enumeration date
12/31/2006
Last updated
06/15/2009
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