Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1134638950 |
---|---|
Provider Name | Arianny Familia Perdomo |
First Address | Brooklyn, NY 11214-4761 |
Second Address | Brooklyn, NY 11214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 25/09/2017 |