Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 010419 | NY |
N | 225XM0800X | Mental Health | 010419 | NY |
NPI | 1578874707 |
---|---|
Provider Name | Ms. Jennifer Richman |
First Address | Brooklyn, NY 11230-6456 |
Second Address | New York, NY 10040-1602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2010 |
Last Update Date | 21/07/2015 |