Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 109018-01 | NY |
NPI | 1023546934 |
---|---|
Provider Name | Dr. Jenna Nicole Duncalf |
First Address | New York, NY 10019-2831 |
Second Address | New York, NY 10019-2831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2017 |
Last Update Date | 12/03/2021 |