Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 071920 | NY |
NPI | 1003010034 |
---|---|
Provider Name | Ms. Maureen Theresa Sheehan |
First Address | Bronx, NY 10471-3065 |
Second Address | New York, NY 10003-4717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |