Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 092897 | NY |
Y | 1041C0700X | Clinical Social Worker | 086322 | NY |
NPI | 1003241324 |
---|---|
Provider Name | Amanda Nicole Greenspan |
First Address | New York, NY 10022-2661 |
Second Address | New York, NY 10022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2013 |
Last Update Date | 30/05/2019 |