Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1694932 | NY |
NPI | 1043527344 |
---|---|
Provider Name | Nicole Alexakis |
First Address | Brooklyn, NY 11214-2263 |
Second Address | Brooklyn, NY 11214-2263 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 08/09/2010 |