Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 959202475 | NY |
NPI | 1003299728 |
---|---|
Provider Name | Emma Ryan Nutter |
First Address | New York, NY 10037-1508 |
Second Address | New York, NY 10037-1508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 30/06/2015 |