Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1548751399 |
---|---|
Provider Name | Cornelius Mcfarland |
First Address | Monticello, NY 12701-1157 |
Second Address | Monticello, NY 12701-1157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2018 |
Last Update Date | 16/06/2018 |