| NPI | 1386122489 |
|---|---|
| Doing Business As | TRISTATE SPORTPSYCH |
| Entity Type | Organization |
| Authorized Contact | MIKE GROSS Licensed Psychologist 908-913-0637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TE1100X Psychologist, Exercise & Sports (Licence: NJ 35SI00577700) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NJ 35SI00577700) |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00577700) | |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2021-08-26 |