Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 078250-1 | NY |
NPI | 1003186776 |
---|---|
Provider Name | Melitza Acevedo |
First Address | Yonkers, NY 10701-2656 |
Second Address | Yonkers, NY 10703-3402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2012 |
Last Update Date | 11/01/2012 |