Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | PR019006-1 | NY |
NPI | 1003146176 |
---|---|
Provider Name | Barbara Bodnar |
First Address | White Plains, NY 10605-1403 |
Second Address | White Plains, NY 10605-1403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2010 |
Last Update Date | 12/01/2010 |