Individual
JUANITA SHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
462 1ST AVE, 20WEST40, NEW YORK, NY 10016-9196
(212) 562-4509
(212) 263-0202
Mailing address
906 GERARD AVE, BRONX, NY 10452-9404
(718) 681-7562
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016148
NY
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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