Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1053769497 |
---|---|
Provider Name | Nadiushka Moquete |
First Address | Middle Village, NY 11379-2100 |
Second Address | Middle Village, NY 11379-2100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 26/08/2016 |