Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | NY | |
N | 101YS0200X | School Counselor | 638651 | NY |
NPI | 1164804027 |
---|---|
Provider Name | Ms. Yolanda Abed Lucas |
First Address | East Patchogue, NY 11772-4753 |
Second Address | Selden, NY 11784-2554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2015 |
Last Update Date | 26/06/2015 |