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General NPI Number Information
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NPI Number | 1407201999
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Entity Type | Organization
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Legal Business Name | NYC CBTP
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Dates
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Enumeration Date | 05/03/2016
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 142 JORALEMON ST STE 5F
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City | BROOKLYN
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State | NY
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Zip | 11201-4709
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Country | US
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Telephone | 347-781-4369
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Fax |
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Provider Business Mailing Address
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Address Line | 142 JORALEMON ST STE 5F
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City | BROOKLYN
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State | NY
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Zip | 11201-4709
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER & DIRECTOR
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Name | SALLY RIGGS
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Credential | DCLINPSY
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Telephone | 347-781-4369
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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 | 018926
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License Number State | NY
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