Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1053990374 |
---|---|
Provider Name | Kristen Stair |
First Address | West Harrison, NY 10604-1049 |
Second Address | West Harrison, NY 10604-1049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2021 |
Last Update Date | 05/04/2021 |