Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 003007-1 | NY |
N | 103TS0200X | School Psychologist | 726131961 | NY |
NPI | 1013018233 |
---|---|
Provider Name | Mrs. Chantal Eugenie Beaudeau |
First Address | New Hyde Park, NY 11040-3034 |
Second Address | New Hyde Park, NY 11040-3034 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 09/02/2018 |