| NPI | 1225341092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN STEVEN WALLACE Director 856-881-1666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00165300) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-07-21 |