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General NPI Number Information
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NPI Number | 1295356822
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Entity Type | Individual
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Provider Name | DARA ISABELLE RITTER
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Gender | Female
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 347 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10016-5010
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Country | US
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Telephone | 413-471-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 3334 CRESCENT ST APT 3A
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City | ASTORIA
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State | NY
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Zip | 11106-3818
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Country | US
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Telephone | 347-414-0044
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 010459
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License Number State | NY
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