Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 003424 | NY |
N | 101YM0800X | Mental Health Counselor |
NPI | 1003055880 |
---|---|
Provider Name | Ms. Cecelia M Telsey |
First Address | Forest Hills, NY 11375-2999 |
Second Address | Forest Hills, NY 11375-2999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 18/02/2009 |