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General NPI Number Information
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NPI Number | 1952831125
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Entity Type | Organization
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Legal Business Name | MINDFULNESS PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 06/21/2017
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Provider Practice Location Address
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Address Line | 7050 AUSTIN ST STE 108
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City | FOREST HILLS
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State | NY
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Zip | 11375-4746
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Country | US
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Telephone | 347-449-0165
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Fax |
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Provider Business Mailing Address
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Address Line | 5608 VAN CLEEF ST
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City | CORONA
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State | NY
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Zip | 11368-4026
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Country | US
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Telephone | 347-449-0165
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/SOLE OWNER
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Name | DAISY LIZETTE SALVIA
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Credential | PSY.D.
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Telephone | 347-449-0165
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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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