Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 078706-1 | NY |
NPI | 1003194408 |
---|---|
Provider Name | Megan Spina |
First Address | Brooklyn, NY 11217-2812 |
Second Address | Brooklyn, NY 11217-2812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2011 |
Last Update Date | 29/02/2012 |