Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 007799-01 | NY |
NPI | 1003201385 |
---|---|
Provider Name | Brittany Hennessey |
First Address | Gloversville, NY 12078-3968 |
Second Address | Gloversville, NY 12078-3968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 28/04/2021 |