Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1914866 | NY |
NPI | 1063726958 |
---|---|
Provider Name | Ms. Lisette Pedreira |
First Address | Brooklyn, NY 11211-2516 |
Second Address | Brooklyn, NY 11211-2516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2010 |
Last Update Date | 21/09/2012 |