Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | NY |
NPI | 1013488576 |
---|---|
Provider Name | Barbra Talley |
First Address | Staten Island, NY 10304 |
Second Address | Bronx, NY 10459-5202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2018 |
Last Update Date | 10/12/2018 |