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General NPI Number Information
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NPI Number | 1174897854
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Entity Type | Individual
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Provider Name | ANNE DALEBROUX MYKYTA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | 341 EAST 79TH STREET STE. 302
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City | NEW YORK
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State | NY
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Zip | 10075
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Country | US
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Telephone | 917-740-5202
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Fax |
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Provider Business Mailing Address
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Address Line | 341 EAST 79TH STREET STE. 302
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City | NEW YORK
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State | NY
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Zip | 10075
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Country | US
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Telephone | 917-740-5202
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 530023111
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 533364111
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 022230-1
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License Number State | NY
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