Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 837065 | NY |
NPI | 1093052524 |
---|---|
Provider Name | Ms. Rebecca Garner |
First Address | Watertown, NY 13601 |
Second Address | Watertown, NY 13601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2013 |
Last Update Date | 03/01/2013 |