Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | NY |
NPI | 1033605803 |
---|---|
Provider Name | Gabrielle Reyes |
First Address | New York, NY 10001-2320 |
Second Address | New York, NY 10001-2320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2018 |
Last Update Date | 07/01/2019 |