Individual
MR. ROBERT TEITELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
103 W SENECA ST, ITHACA, NY 14850-4157
(607) 379-4191
Mailing address
212 MONROE ST, ITHACA, NY 14850-3444
(607) 272-9454
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000628
NY
Other
Enumeration date
01/23/2007
Last updated
12/29/2012
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