Individual
AVA HOSP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MAPLE MOOR LN, CORTLANDT MANOR, NY 10567-6419
(914) 582-3732
Mailing address
1 MAPLE MOOR LN, CORTLANDT MANOR, NY 10567-6419
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
861318141
NY
Other
Enumeration date
06/29/2015
Last updated
10/02/2015
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