Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | ||
Y | 103TS0200X | School Psychologist | 1708578 | NY |
NPI | 1013681691 |
---|---|
Provider Name | Ms. Tasha Benbow |
First Address | Poughkeepsie, NY 12603-3803 |
Second Address | Poughkeepsie, NY 12603-3803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2021 |
Last Update Date | 10/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1708578 | NYS EDUCATION DEPARTMENT (01) | NY |