Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 080100-1 | NY |
NPI | 1003571787 |
---|---|
Provider Name | Lynsey Wolfson |
First Address | Port Washington, NY 11050-4339 |
Second Address | Port Washington, NY 11050-4339 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2021 |
Last Update Date | 08/11/2021 |