Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 023029 | NY |
NPI | 1043772049 |
---|---|
Provider Name | Kyle Haney |
First Address | New York, NY 10022-5638 |
Second Address | New York, NY 10022-5638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2019 |
Last Update Date | 01/04/2019 |