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General NPI Number Information
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NPI Number | 1811611742
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Entity Type | Organization
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Legal Business Name | JESSICA SUZUKI PHD PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 125 E 23RD ST # 4033
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City | NEW YORK
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State | NY
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Zip | 10010-4511
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Country | US
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Telephone | 901-646-1024
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Fax |
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Provider Business Mailing Address
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Address Line | 503 50TH AVE APT 3C
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-5710
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Country | US
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Telephone | 212-961-7176
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Fax |
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Authorized Official
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Title or Position | OWNER/SENIOR PSYCHOLOGIST
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Name | JESSICA SUZUKI
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Credential | PHD
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Telephone | 901-646-1024
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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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