Healthcare Provider Details

I. General information

NPI: 1104379809
Provider Name (Legal Business Name): DALITA PAULINE GETZOYAN LCAT, MT-BC, MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MICHIGAN AVE STE 1200
CHICAGO IL
60611-3959
US

IV. Provider business mailing address

539 LENOX AVE APT 3E
NEW YORK NY
10037-1817
US

V. Phone/Fax

Practice location:
  • Phone: 347-480-8250
  • Fax:
Mailing address:
  • Phone: 401-486-2659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number002721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: