Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 103TS0200X | NY |
NPI | 1033884457 |
---|---|
Provider Name | Cheyenne Clardy |
First Address | New York, NY 10017-5832 |
Second Address | New York, NY 10017-5832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2021 |
Last Update Date | 09/08/2021 |