Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 18P68758 | NY |
N | 103TC1900X | Counseling Psychologist | 18P68758 | NY |
NPI | 1104069236 |
---|---|
Provider Name | Ms. Sabrina Gayle Musson |
First Address | Buffalo, NY 14202-1102 |
Second Address | Buffalo, NY 14202-1102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2009 |
Last Update Date | 03/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00932467 | (05) | NY |