Individual
DR. JASON ROYAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2095 BROADWAY RM 304, NEW YORK, NY 10023-2895
(646) 588-1325
Mailing address
2095 BROADWAY RM 304, NEW YORK, NY 10023-2895
(646) 588-1325
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
020713
NY
Other
Enumeration date
08/05/2014
Last updated
12/14/2020
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