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General NPI Number Information
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NPI Number | 1063928372
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Entity Type | Organization
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Legal Business Name | AURORA PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | 92 PROSPECT PL
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City | BROOKLYN
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State | NY
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Zip | 11217-2804
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Country | US
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Telephone | 347-770-7631
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Fax |
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Provider Business Mailing Address
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Address Line | 92 PROSPECT PL
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City | BROOKLYN
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State | NY
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Zip | 11217-2804
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Country | US
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Telephone | 347-770-7631
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DIANA MOROZOV
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Credential | PSY.D.
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Telephone | 347-770-7631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 020920-1
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License Number State | NY
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