Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | NY |
NPI | 1003281932 |
---|---|
Provider Name | Ms. Gillian David |
First Address | Brooklyn, NY 11236-3502 |
Second Address | New York, NY 10038-4812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2015 |
Last Update Date | 03/12/2015 |