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General NPI Number Information
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NPI Number | 1194329953
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Entity Type | Individual
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Provider Name | WALKENS PETIT-FRERE LMSW
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Gender | Male
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 348 13TH ST STE 203
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City | BROOKLYN
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State | NY
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Zip | 11215-6179
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Country | US
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Telephone | 917-499-9876
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Fax |
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Provider Business Mailing Address
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Address Line | 2427 ADAM CLAYTON POWELL JR BLVD APT 2A
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City | NEW YORK
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State | NY
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Zip | 10030-1770
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Country | US
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Telephone | 917-499-9876
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 112377
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License Number State | NY
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