Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | R054330-1 | NY |
NPI | 1003156167 |
---|---|
Provider Name | Mrs. Sophia L Parker |
First Address | Yonkers, NY 10710-4231 |
Second Address | Montrose, NY 10548-1454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2013 |
Last Update Date | 26/02/2013 |