Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 016586 | NY |
NPI | 1063683035 |
---|---|
Provider Name | Dr. Cicely N Horsham-Brathwaite |
First Address | New York, NY 10001-4406 |
Second Address | New York, NY 10001-4406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2008 |
Last Update Date | 20/09/2016 |