Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 024611 | NY |
Y | 103G00000X | Clinical Psychologist | 024611 | NY |
Y | 103TC0700X | Clinical Psychologist | 024611 | NY |
NPI | 1073277430 |
---|---|
Provider Name | Dr. Jaime Ashley Coffino |
First Address | New York, NY 10010-5519 |
Second Address | New York, NY 10010-5519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2021 |
Last Update Date | 22/10/2021 |