Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 072847 | NY |
NPI | 1003161332 |
---|---|
Provider Name | Cristina Lima |
First Address | Harrison, NY 10528-1140 |
Second Address | Harrison, NY 10528-1140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2012 |
Last Update Date | 24/07/2012 |