Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003451089 |
---|---|
Provider Name | Talya Sahler |
First Address | Monroe, NY 10950-2023 |
Second Address | Monroe, NY 10950-2923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2019 |
Last Update Date | 13/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S08918180 | DRIVERS LICENSE (01) | MA |