Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 071968 | NY |
NPI | 1003189804 |
---|---|
Provider Name | Patricia K. Plaisted |
First Address | Elmira, NY 14901-3332 |
Second Address | Elmira, NY 14901-3332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2012 |
Last Update Date | 10/02/2012 |