Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 067001-1 | NY |
N | 101YS0200X | School Counselor | 067001-1 | NY |
NPI | 1164975686 |
---|---|
Provider Name | Ms. Natacha Ivelis Gonzalez |
First Address | Sea Cliff, NY 11579-1005 |
Second Address | Sea Cliff, NY 11579-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2016 |
Last Update Date | 02/08/2016 |