Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1053996512 |
---|---|
Provider Name | Caitlin Bahr |
First Address | New York, NY 10038-4812 |
Second Address | New York, NY 10038-4812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2021 |
Last Update Date | 16/03/2021 |