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General NPI Number Information
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NPI Number | 1063123842
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Entity Type | Organization
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Legal Business Name | AMY LEE PSYCHOLOGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 12/12/2022
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 8011 18TH AVE FL 2
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City | BROOKLYN
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State | NY
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Zip | 11214-1705
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Country | US
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Telephone | 646-517-0708
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 18TH AVE FL 2
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City | BROOKLYN
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State | NY
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Zip | 11214-1705
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Country | US
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Telephone | 646-517-0708
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. AMY LEE
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Credential | PSY.D., BCBA, PMH-C
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Telephone | 646-517-0708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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