Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | R013078 | NY |
NPI | 1003071853 |
---|---|
Provider Name | Ms. Marguerite Stratton |
First Address | Ny, NY 10019 |
Second Address | Ny, NY 10019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2008 |
Last Update Date | 22/07/2008 |