Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 072286-1 | NY |
NPI | 1003187378 |
---|---|
Provider Name | Mr. Clinton Paige Norwood JR. |
First Address | Utica, NY 13501 |
Second Address | Utica, NY 13501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 15/12/2016 |