Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1594352 | NY |
NPI | 1053792994 |
---|---|
Provider Name | Ms. Richelle Tordoff |
First Address | Buffalo, NY 14216-1455 |
Second Address | Depew, NY 14043-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 16/06/2015 |