Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | NY |
NPI | 1023158557 |
---|---|
Provider Name | Mrs. Sara Jeanne Wells-Henry |
First Address | Lake Ronkonkoma, NY 11779-1907 |
Second Address | Huntington, NY 11743-4529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 25/07/2007 |