Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 102157-1 | NY |
NPI | 1003474669 |
---|---|
Provider Name | Tatyana Krychkina |
First Address | Cortlandt Manor, NY 10567-4145 |
Second Address | Dobbs Ferry, NY 10522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2019 |
Last Update Date | 30/05/2019 |