Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 006173-1 | NY |
NPI | 1144410861 |
---|---|
Provider Name | Dr. Ethell Ann Geller |
First Address | New York, NY 10075-1740 |
Second Address | New York, NY 10075-1740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 30/07/2007 |