Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1235795238 |
---|---|
Provider Name | Kelly Patterson |
First Address | Wallkill, NY 12589-2829 |
Second Address | Monticello, NY 12701-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2019 |
Last Update Date | 11/06/2019 |