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Individual

MS. JESSICA KATHERINE MASTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
501 FIFTH AVENUE, SUITE 1709, NEW YORK, NY 10017-6129
(516) 661-4603
(914) 423-9434
Mailing address
501 FIFTH AVENUE, SUITE 1709, NEW YORK, NY 10017-6129
(516) 661-4603
(914) 423-9434

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
68-021189
NY
103TC0700X
Clinical Psychologist
68-021189
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/23/2009
Last updated
07/21/2022
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