Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1013583863 |
---|---|
Provider Name | Roselin M Graciano |
First Address | Forest Hills, NY 11375-4739 |
Second Address | Forest Hills, NY 11375-1022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2021 |
Last Update Date | 02/06/2021 |