Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1063925402 |
---|---|
Provider Name | Kathryn Strunk |
First Address | Atlantic Beach, NY 11509-1126 |
Second Address | Atlantic Beach, NY 11509-1126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2017 |
Last Update Date | 08/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2199078 | SCHOOL PSYCHOLOGIST CERTIFICATE (01) | NY |