Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 060609 | NY |
Y | 1041C0700X | Clinical Social Worker | 071904 | NY |
NPI | 1003069030 |
---|---|
Provider Name | Ms. Louise Ann Abitbol |
First Address | Shelter Island Heights, NY 11965-0106 |
Second Address | Shelter Island, NY 11965-0106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2008 |
Last Update Date | 17/06/2011 |