Provider Demographics
NPI:1104379809
Name:GETZOYAN, DALITA PAULINE (LCAT, MT-BC, MA)
Entity Type:Individual
Prefix:
First Name:DALITA
Middle Name:PAULINE
Last Name:GETZOYAN
Suffix:
Gender:F
Credentials:LCAT, MT-BC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 LENOX AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1817
Mailing Address - Country:US
Mailing Address - Phone:401-486-2659
Mailing Address - Fax:
Practice Address - Street 1:444 N MICHIGAN AVE STE 1200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3959
Practice Address - Country:US
Practice Address - Phone:347-480-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY002721225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health