Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 091460-1 |
NPI | 1003235714 |
---|---|
Provider Name | Mrs. Bracha Bersson |
First Address | Far Rockaway, NY 11691-5173 |
Second Address | Brooklyn, NY 11219-2059 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 09/04/2014 |