Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 645P26142 | NY |
NPI | 1003041252 |
---|---|
Provider Name | Richard Sanchez |
First Address | White Plains, NY 10605-4103 |
Second Address | White Plains, NY 10605-4103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2009 |
Last Update Date | 18/05/2009 |