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General NPI Number Information
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NPI Number | 1871806380
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Entity Type | Individual
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Provider Name | MICHELLE CARITTA WILTSHIRE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2010
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 220 5TH AVE SUITE 300
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City | NEW YORK
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State | NY
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Zip | 10001-7708
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Country | US
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Telephone | 858-207-7364
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Fax |
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Provider Business Mailing Address
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Address Line | 150 LINCOLN BLVD APT 3312
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City | MIDDLESEX
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State | NJ
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Zip | 08846-1060
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Country | US
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Telephone | 858-207-7364
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 021478
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License Number State | NY
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