Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1205777 | NY |
NPI | 1053563429 |
---|---|
Provider Name | Maria Gaudio |
First Address | Bronx, NY 10461-1329 |
Second Address | Bronx, NY 10461-1329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2008 |
Last Update Date | 16/10/2008 |