Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 0931291 | NY |
NPI | 1003359712 |
---|---|
Provider Name | Judith Liu |
First Address | New Rochelle, NY 10801-6347 |
Second Address | New Rochelle, NY 10801-6347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2016 |
Last Update Date | 14/09/2021 |