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General NPI Number Information
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NPI Number | 1356072698
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Entity Type | Organization
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Legal Business Name | DR. TULSA KNOX PSYCHOLOGIAL SERVICES, PLLC
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 25 8TH AVE STE B
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City | BROOKLYN
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State | NY
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Zip | 11217-3755
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Country | US
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Telephone | 845-702-8764
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Fax |
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Provider Business Mailing Address
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Address Line | 124 RITCH AVE W APT A303
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City | GREENWICH
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State | CT
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Zip | 06830-6965
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Country | US
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Telephone | 845-702-8764
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TULSA KNOX
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Credential | PSY.D
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Telephone | 845-702-8764
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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 |
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License Number State |
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