Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 054047-1 | NY |
NPI | 1003110636 |
---|---|
Provider Name | Ms. Phyllis L. Adler |
First Address | Albany, NY 12203-3537 |
Second Address | Albany, NY 12203-3537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2010 |
Last Update Date | 30/09/2021 |