Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003572306 |
---|---|
Provider Name | Carmen Mui |
First Address | Brooklyn, NY 11223-2732 |
Second Address | Brooklyn, NY 11223-2732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2021 |
Last Update Date | 10/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
553705546 | DRIVER'S LICENSE (01) | NY |