Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 19424 | NY |
NPI | 1144370487 |
---|---|
Provider Name | Ms. Helene Sylvia Goldberg |
First Address | Woodmere, NY 11598 |
Second Address | Woodmere, NY 11598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00244817 | (05) | NY |
19424 | CRCC (01) | NY |