Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 114345 | NY |
NPI | 1003570177 |
---|---|
Provider Name | Lauren Sammis |
First Address | Patchogue, NY 11772-3641 |
Second Address | Islandia, NY 11749-1555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2021 |
Last Update Date | 26/10/2021 |