Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 094851 | NY |
NPI | 1003479767 |
---|---|
Provider Name | Mrs. Rachelle Mary Partridge |
First Address | Bath, NY 14810-1129 |
Second Address | Bath, NY 14810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2019 |
Last Update Date | 18/04/2019 |