Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 098698 | NY |
NPI | 1003318064 |
---|---|
Provider Name | Sarah Freeze |
First Address | Huntington, NY 11743-4231 |
Second Address | Huntington, NY 11743-4231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2018 |
Last Update Date | 06/03/2018 |