| NPI | 1205609872 |
|---|---|
| Doing Business As | GARDEN STATE PSYCH |
| Entity Type | Organization |
| Authorized Contact | GRANT MYERS Exective Member 732-301-6904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-11-03 |
| Last Update Date | 2023-11-03 |