Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1780082032 |
---|---|
Provider Name | Ms. Christina Maria Stibely |
First Address | Staten Island, NY 10301 |
Second Address | Staten Island, NY 10301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2014 |
Last Update Date | 10/03/2015 |