Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 1133855 | NY |
NPI | 1104112275 |
---|---|
Provider Name | Jo Ann Cleghorne |
First Address | Floral Park, NY 11001-3823 |
Second Address | Floral Park, NY 11001-3823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2011 |
Last Update Date | 27/06/2011 |