Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003316415 |
---|---|
Provider Name | Larissa Dos Santos Garcez |
First Address | South Hempstead, NY 11550-8021 |
Second Address | South Hempstead, NY 11550-8021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2018 |
Last Update Date | 13/02/2018 |