Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 009984 | NY |
NPI | 1043421381 |
---|---|
Provider Name | Dr. Nicola Beckles |
First Address | Amityville, NY 11701-0085 |
Second Address | Amityville, NY 11701-2780 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 12/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01183884 | (05) | NY |