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General NPI Number Information
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NPI Number | 1326344565
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Entity Type | Individual
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Provider Name | MS. CAROLE GAUTHIER
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Gender | Female
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Dates
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Enumeration Date | 02/06/2011
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 36 W 25TH ST 10TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10010-2706
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Country | US
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Telephone | 917-488-0596
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Fax |
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Provider Business Mailing Address
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Address Line | 41 RIVER TER APT 904
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City | NEW YORK
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State | NY
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Zip | 10282-1113
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Country | US
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Telephone | 917-488-0596
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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 | 000861
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License Number State | NY
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