Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 069773-1 | NY |
NPI | 1992920854 |
---|---|
Provider Name | Debra Sollitto |
First Address | Staten Island, NY 10312-3314 |
Second Address | Staten Island, NY 10312-3314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 01/10/2016 |