Provider Demographics
NPI:1558690800
Name:SPALDING, ANN (ATR, LCAT, LP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:SPALDING
Suffix:
Gender:F
Credentials:ATR, LCAT, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 1ST AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-7908
Mailing Address - Country:US
Mailing Address - Phone:212-475-3504
Mailing Address - Fax:
Practice Address - Street 1:853 BROADWAY
Practice Address - Street 2:SUITE 1501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4703
Practice Address - Country:US
Practice Address - Phone:212-475-3504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000480-1102L00000X
NY000382221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist