Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 114995 | NY |
NPI | 1003574070 |
---|---|
Provider Name | Ms. Monique Zellars |
First Address | New York, NY 10030-1968 |
Second Address | Brooklyn, NY 11230-1904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2021 |
Last Update Date | 07/12/2021 |