Individual
MARISELA HUERTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
21 BLOOMINGDALE RD, WHITE PLAINS, NY 10605-1504
(914) 997-5947
Mailing address
1161 YORK AVE, APT. 2M, NEW YORK, NY 10065-7940
(773) 936-9777
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301014769
MI
103TC0700X
Clinical Psychologist
Primary
68019264
NY
Other
Enumeration date
07/22/2011
Last updated
03/06/2013
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