Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 04211845 | NY |
NPI | 1003028689 |
---|---|
Provider Name | Ms. Vivian Fields |
First Address | Brooklyn, NY 11238-2402 |
Second Address | Brooklyn, NY 11217-1706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |