Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 752359131 | NY |
NPI | 1053746206 |
---|---|
Provider Name | Ms. Alysse Daansen Foster |
First Address | Canandaigua, NY 14424-7964 |
Second Address | Canandaigua, NY 14424-7964 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2013 |
Last Update Date | 06/09/2013 |