Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 2816298 | NY |
NPI | 1023624145 |
---|---|
Provider Name | Karleen Marie Gabriel |
First Address | Smithtown, NY 11787-5419 |
Second Address | Smithtown, NY 11787-5419 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2020 |
Last Update Date | 23/09/2020 |