Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 021833 | NY |
NPI | 1033637723 |
---|---|
Provider Name | Dr. Heather Erin Cosgrove |
First Address | New Hartford, NY 13413-2308 |
Second Address | Clinton, NY 13323-1218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2017 |
Last Update Date | 02/09/2017 |