Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 082055 | NY |
NPI | 1003115007 |
---|---|
Provider Name | Susan Marie Reed |
First Address | Brooklyn, NY 11209-7104 |
Second Address | Brooklyn, NY 11209-7104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2011 |
Last Update Date | 11/01/2017 |