Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003495722 |
---|---|
Provider Name | Nicole Drey |
First Address | Malverne, NY 11565-1738 |
Second Address | Valley Stream, NY 11580-6223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2021 |
Last Update Date | 09/09/2021 |