Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 0144021 | NY |
NPI | 1023100617 |
---|---|
Provider Name | Debra Jean Pietrangelo |
First Address | Queensbury, NY 12804-2133 |
Second Address | Queensbury, NY 12804-2133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02145628 | (05) | NY |