| NPI | 1144242157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE L MCLEAN Owner 732-548-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NJ 37PC00033700) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NJ 37PC00033700) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-09-24 |