Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 970219 | NJ |
NPI | 1033662861 |
---|---|
Provider Name | Amy Nevo |
First Address | Passaic, NJ 07055-3320 |
Second Address | Clifton, NJ 07012-1941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2016 |
Last Update Date | 28/07/2016 |