Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 075730-1 | NY |
NPI | 1003031501 |
---|---|
Provider Name | Lynda Guzman |
First Address | Carmel, NY 10512-2454 |
Second Address | Carmel, NY 10512-2454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/09/2008 |