Individual
GABRIELLE FRACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
710 W 168TH ST # NI-12, NEW YORK, NY 10032
(212) 305-9758
(212) 342-1699
Mailing address
710 W 168TH ST, NEW YORK, NY 10032-3726
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
022865
NY
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
022865
NY
Other
Enumeration date
09/25/2017
Last updated
11/01/2023
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