| NPI | 1104132026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ETTS Psychotherapist 732-213-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44sc05321300) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37lc00101000) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |