Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1143586171 | NY |
NPI | 1003337239 |
---|---|
Provider Name | Filana Guelfenboim |
First Address | Staten Island, NY 10306-4334 |
Second Address | Staten Island, NY 10308-2409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2017 |
Last Update Date | 28/06/2017 |