Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 991184 | NY |
NPI | 1013350024 |
---|---|
Provider Name | Mr. Matthew Nordenhold |
First Address | White Plains, NY 10603-1715 |
Second Address | White Plains, NY 10603-1715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 09/04/2013 |