Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1154544286 |
---|---|
Provider Name | Miss Jennifer Ledezma |
First Address | Bronx, NY 10458-1454 |
Second Address | Bronx, NY 10467-1052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |