Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 079824 | NY |
Y | 1041C0700X | Clinical Social Worker | 0804681 | NY |
NPI | 1003144007 |
---|---|
Provider Name | Ms. Carly Giglia |
First Address | South Ozone Park, NY 11420-2122 |
Second Address | South Ozone Park, NY 11420-2122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2009 |
Last Update Date | 08/03/2013 |