Most Relevant Information
Provider Data
| NPI Number: | 1003338161 |
| Provider Name: | SOUDABEH SHAYESTEH |
| Entity Type: | Individual |
| Taxonomy Code: | 103TS0200X |
| Specialty: | Psychologist |
| License Number: | 14006 |
Most Important Dates
| Enumeration Date: | 07/11/2017 |
| Last Updated: | 07/20/2017 |
Provider Practice Location
404 3RD ST APT A4
BROOKLYN
NY
112152836
Practice Location Phone/Fax
| Phone: | 6462842767 |
| Fax: | 6462842767 |
Provider Mailing Location
PO BOX 417
BROOKLYN
NY
112150417
Provider Mailing Phone/Fax
| Phone: | 6462842767 |
| Fax: |