Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 1041C0700X | Clinical Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | 080202 | NY |
NPI | 1003953845 |
---|---|
Provider Name | Mrs. Coco Meng |
First Address | Oakland Gardens, NY 11364-2711 |
Second Address | Flushing, NY 11355-2557 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 09/11/2010 |