Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1083040646 |
---|---|
Provider Name | Theresa F Brandow |
First Address | Farmingville, NY 11738-3037 |
Second Address | Farmingville, NY 11738-3037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2013 |
Last Update Date | 16/09/2013 |