Individual
DR. BRENT IVAN BOUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
276 5TH AVE STE 507B.6, NEW YORK, NY 10001-4509
(646) 455-3539
Mailing address
149 W 95TH ST APT A, NEW YORK, NY 10025-6650
(917) 833-7935
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
019071
NY
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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