Individual
IDA JELTOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
017255
NY
103TC0700X
Clinical Psychologist
035SI00527700
NJ
103TS0200X
School Psychologist
Primary
017255
NY
Other
Enumeration date
07/31/2007
Last updated
10/30/2021
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