Individual
MALLORY SEIDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
16 INNESS PL, MONTCLAIR, NJ 07042-4923
(917) 426-7158
Mailing address
16 INNESS PL, MONTCLAIR, NJ 07042-4923
(917) 426-7158
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
021231
NY
103G00000X
Clinical Neuropsychologist
Primary
35SI00571000
NJ
103TC0700X
Clinical Psychologist
021231
NY
103TC0700X
Clinical Psychologist
35SI00571000
NJ
Other
Enumeration date
07/14/2014
Last updated
02/03/2020
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