Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1174875322 |
---|---|
Provider Name | Miss Maryann J Stevens |
First Address | New York, NY 10016-7351 |
Second Address | Huntington, NY 11743-7400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2012 |
Last Update Date | 12/10/2012 |