Doctor Name: | IRIS AVISHAI |
NPI Number: | 1073600250 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | R042701 |
Business Practice Address: | 153 Butterville Rd New Paltz, NY - 125612803 |
Business Phone Number: | 2126640152 |
Business Fax Number: | 8452556896 |
Mailing Address: | 153 Butterville Rd, NEW PALTZ |
State: | NY |
Postal Code: | 125612803 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | R042701 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |