Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 104100000X | Social Worker | 114166 | NY |
NPI | 1003481722 |
---|---|
Provider Name | Christina Duncan |
First Address | New York, NY 10012-4082 |
Second Address | New York, NY 10017-5832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2021 |
Last Update Date | 26/10/2021 |