Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003276569 |
---|---|
Provider Name | Charisse James |
First Address | Brooklyn, NY 11216-3801 |
Second Address | Bronx, NY 10468-3904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2016 |
Last Update Date | 26/02/2016 |