Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 091277 | NY |
Y | 1041C0700X | Clinical Social Worker | 10310 | CT |
NPI | 1003398173 |
---|---|
Provider Name | Miss Alexis Schwach |
First Address | Ossining, NY 10562-2034 |
Second Address | White Plains, NY 10605-1820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2018 |
Last Update Date | 05/09/2018 |