Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 001020 | NY |
Y | 103T00000X | Psychologist | 001020 | NY |
NPI | 1013407386 |
---|---|
Provider Name | Katheryn Soleil |
First Address | Brooklyn, NY 11231-1532 |
Second Address | New York, NY 10010-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2018 |
Last Update Date | 13/05/2018 |