Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 100899-1 | NY |
NPI | 1003382235 |
---|---|
Provider Name | Leah Bodner |
First Address | Brooklyn, NY 11206-5415 |
Second Address | Brooklyn, NY 11219-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2018 |
Last Update Date | 15/10/2018 |