Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 091715 - 1 | NY |
NPI | 1003165861 |
---|---|
Provider Name | Mrs. Massielle Morales-Miller |
First Address | New York, NY 10029-6574 |
Second Address | New York, NY 10029-6574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2012 |
Last Update Date | 19/08/2015 |