Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | NY |
NPI | 1023323458 |
---|---|
Provider Name | Mrs. Victoria Kristal-Kotlyar |
First Address | New York, NY 10025-6721 |
Second Address | New York, NY 10025-6721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2010 |
Last Update Date | 07/09/2012 |