Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 33151 | NY |
NPI | 1003454836 |
---|---|
Provider Name | Victoria Lyn Spahn |
First Address | Amityville, NY 11701-2508 |
Second Address | Amityville, NY 11701-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2019 |
Last Update Date | 11/12/2019 |