Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 81165 | CA |
N | 104100000X | Social Worker |
NPI | 1003379397 |
---|---|
Provider Name | Demetra Cargar |
First Address | Brooklyn, NY 11234-3215 |
Second Address | Brooklyn, NY 11234-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2019 |
Last Update Date | 03/02/2022 |