Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 023610 | NY |
NPI | 1114540648 |
---|---|
Provider Name | Dr. Alexandra Lerner |
First Address | Ithaca, NY 14850-9458 |
Second Address | Ithaca, NY 14850-9458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2020 |
Last Update Date | 19/05/2020 |