Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 081428-1 | NY |
N | 1041C0700X | Clinical Social Worker | 44SC05553000 | NJ |
NPI | 1003242843 |
---|---|
Provider Name | Patrice Carrieri |
First Address | West Nyack, NY 10994-2240 |
Second Address | West Nyack, NY 10994-2240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2013 |
Last Update Date | 25/09/2013 |