Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP1600X | Pastoral Counselor |
NPI | 1235622473 |
---|---|
Provider Name | Joanna M Mercuri |
First Address | New York, NY 10021-0514 |
Second Address | New York, NY 10023-7603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2018 |
Last Update Date | 12/06/2018 |