Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003266081 |
---|---|
Provider Name | Kaitlyn Yale |
First Address | Lynbrook, NY 11563-3317 |
Second Address | Lynbrook, NY 11563-3317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2016 |
Last Update Date | 21/06/2016 |