Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | 091701 | NY |
NPI | 1003281650 |
---|---|
Provider Name | Lauren Navarra |
First Address | Bayville, NY 11709-1008 |
Second Address | Bayville, NY 11709-1008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2015 |
Last Update Date | 02/10/2021 |