Individual
DR. ALEXANDRA DE WAAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
80 MAIDEN LN, NEW YORK, NY 10038-4811
(212) 509-2411
Mailing address
298 GREENE AVE APT 3, BROOKLYN, NY 11238-1410
(646) 283-3561
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
023123
NY
Other
Enumeration date
07/07/2019
Last updated
07/07/2019
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