Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 072247-1 | NY |
NPI | 1003099755 |
---|---|
Provider Name | Mrs. Ann Frances Lawrence |
First Address | Far Rockaway, NY 11691-4008 |
Second Address | Far Rockaway, NY 11691-4008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2007 |
Last Update Date | 17/12/2007 |