Individual
DR. JONATHAN MICHAEL WORMHOUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
460 W 24TH ST APT 1F, NEW YORK, NY 10011-1366
(212) 242-9494
(212) 242-9494
Mailing address
70 E 10TH ST, APATMENT 18D, NEW YORK, NY 10003-5102
(212) 242-9494
(212) 242-9494
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
015443
NY
103T00000X
Psychologist
PSY11307
CA
Other
Enumeration date
01/13/2007
Last updated
07/08/2007
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