Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1023397890 |
---|---|
Provider Name | Danielle Amatuccio |
First Address | Fresh Meadows, NY 11365-3767 |
Second Address | Fresh Meadows, NY 11365-3767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2011 |
Last Update Date | 12/10/2012 |