Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003582743 |
---|---|
Provider Name | Ms. Therese Marie Spillane |
First Address | New York, NY 10036-1144 |
Second Address | New York, NY 10036-1144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2021 |
Last Update Date | 22/08/2021 |