Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 082895 | NY |
Y | 1041C0700X | Clinical Social Worker | 083025 | NY |
NPI | 1003120353 |
---|---|
Provider Name | Cahlelah Lovina Gumbs |
First Address | New York, NY 10037-1520 |
Second Address | New York, NY 10027-4465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2010 |
Last Update Date | 06/07/2015 |