Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 024769 | NY |
N | 103TC0700X | Clinical Psychologist | 024769 | NY |
Y | 103G00000X | Clinical Psychologist | 024769 | NY |
Y | 103TC0700X | Clinical Psychologist | 024769 | NY |
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 024769 | NY |
NPI | 1073131124 |
---|---|
Provider Name | Dr. Monika K. Herrera |
First Address | Ridgewood, NY 11385-5143 |
Second Address | Ridgewood, NY 11385-5143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2020 |
Last Update Date | 05/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390200000X | (05) | NY |