Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | NY |
NPI | 1023261229 |
---|---|
Provider Name | Mrs. Sara Burris Libonati |
First Address | Ridgefield, CT 06877-2007 |
Second Address | Valhalla, NY 10595-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2008 |
Last Update Date | 31/10/2008 |