Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1043857071 |
---|---|
Provider Name | Marissa Albano |
First Address | Purchase, NY 10577-2554 |
Second Address | Purchase, NY 10577-2554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2019 |
Last Update Date | 10/12/2019 |