Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 072665 | NY |
NPI | 1003077215 |
---|---|
Provider Name | Suzanne Helen Deane |
First Address | Albany, NY 12208-3410 |
Second Address | Albany, NY 12208-3410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2008 |
Last Update Date | 22/01/2013 |