Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 021726 | NY |
NPI | 1093249385 |
---|---|
Provider Name | Dr. Diana Haddad |
First Address | Brooklyn, NY 11209-7002 |
Second Address | Brooklyn, NY 11209-8333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2017 |
Last Update Date | 20/07/2017 |