Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP1600X | Pastoral Counselor |
NPI | 1013485085 |
---|---|
Provider Name | Vanessa Guest |
First Address | Bayside, NY 11361-3129 |
Second Address | New Rochelle, NY 10801-5104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2018 |
Last Update Date | 08/11/2018 |