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General NPI Number Information
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NPI Number | 1184725160
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Entity Type | Individual
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Provider Name | LAUREE WOLIN MITCHELL PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 34 PLAZA ST E STE 102
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City | BROOKLYN
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State | NY
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Zip | 11238-5038
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Country | US
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Telephone | 718-399-6852
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PLAZA ST W APT. #6A
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City | BROOKLYN
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State | NY
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Zip | 11217-3748
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Country | US
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Telephone | 718-399-6852
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 016345
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License Number State | NY
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