Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 111801 | NY |
NPI | 1003384231 |
---|---|
Provider Name | Pamela Andrews |
First Address | Brooklyn, NY 11212-8817 |
Second Address | Brooklyn, NY 11212-8817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2018 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133303089 | (05) | NY |