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General NPI Number Information
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NPI Number | 1629511167
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Entity Type | Organization
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Legal Business Name | FREDRIKA STJARNE
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Dates
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Enumeration Date | 12/01/2016
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 15 W 12TH ST APT 1 B
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City | NEW YORK
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State | NY
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Zip | 10011-8546
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Country | US
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Telephone | 917-532-0687
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Fax |
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Provider Business Mailing Address
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Address Line | 15 W 12TH ST APT 1 B
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City | NEW YORK
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State | NY
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Zip | 10011-8546
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Country | US
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Telephone | 917-532-0687
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Fax |
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Authorized Official
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Title or Position | PSYCHOANALYST
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Name | FREDRIKA STJARNE
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Credential | MFA, LP
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Telephone | 917-532-0687
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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 | 000972
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License Number State | NY
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