Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 113319-01 | NY |
NPI | 1003581216 |
---|---|
Provider Name | Shakira Trice |
First Address | New York, NY 10031-6172 |
Second Address | White Plains, NY 10605-2217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 10/08/2021 |