Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 006485 | NY |
NPI | 1003202656 |
---|---|
Provider Name | Amber Bankson |
First Address | New York, NY 10016-7919 |
Second Address | New York, NY 10016-7919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2015 |
Last Update Date | 13/11/2015 |