Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 022714 | NY |
Y | 103T00000X | Psychologist | 022714 | NY |
NPI | 1003390972 |
---|---|
Provider Name | Dr. Jamie T Twaite |
First Address | Forest Hills, NY 11375-3252 |
Second Address | White Plains, NY 10605-2523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 18/09/2018 |