Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 020343 | NY |
NPI | 1114560398 |
---|---|
Provider Name | Dr. Alison Melville Locker |
First Address | New York, NY 10013-2376 |
Second Address | New York, NY 10013-2376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2019 |
Last Update Date | 21/10/2019 |