Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 37AC00204900 | NJ |
Y | 101YP2500X | Professional Counselor | 37PC00714400 | NJ |
NPI | 1003270265 |
---|---|
Provider Name | Rosa Maria Mckoy |
First Address | Bordentown, NJ 08505-1369 |
Second Address | Bordentown, NJ 08505-1369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2016 |
Last Update Date | 08/04/2020 |