Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 017695 | NY |
NPI | 1013158898 |
---|---|
Provider Name | Dr. Joanne Nancy Camille |
First Address | Brooklyn, NY 11238-7451 |
Second Address | Brooklyn, NY 11238-7451 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 06/08/2021 |