Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 089403-1 | NY |
NPI | 1003298944 |
---|---|
Provider Name | Joanne Mclean |
First Address | Staten Island, NY 10314-5866 |
Second Address | Staten Island, NY 10314-5866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2015 |
Last Update Date | 27/06/2015 |