Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 016560 | NY |
N | 103TC0700X | Clinical Psychologist | 016560 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 016560 | NY |
Y | 103G00000X | Clinical Psychologist | 016560 | NY |
Y | 103TC0700X | Clinical Psychologist | 016560 | NY |
N | 103TH0004X | Health Psychologist | 016560 | NY |
N | 103TP2701X | Group Psychotherapist | 016560 | NY |
N | 103TR0400X | Rehabilitation Psychologist | 016560 | NY |
NPI | 1144592312 |
---|---|
Provider Name | Dr. Lisa Maria Wu |
First Address | Brooklyn, NY 11201-4904 |
Second Address | New York, NY 10017-4718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2012 |
Last Update Date | 03/02/2012 |