Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 114387-01 | NY |
NPI | 1003578782 |
---|---|
Provider Name | Kelly Carrone |
First Address | Slingerlands, NY 12159-9231 |
Second Address | Albany, NY 12206-1242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2021 |
Last Update Date | 09/10/2021 |