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1558409532
RICHARD BEVACQUA
LAKEWOOD, NJ
NPI
1558409532
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NJ 44SC00836300)
Enumeration Date
2007-02-02
Last Update Date
2007-07-09
Business Address
-- RICHARD BEVACQUA LCSW
PREFERRED BEHAVIORAL HEALTH SAIL PROGRAM 999 AIRPORT ROAD
LAKEWOOD, NJ 08701
Phone number: 732-367-1710
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Mailing Address
-- RICHARD BEVACQUA LCSW
99 BARK ST
TOMS RIVER, NJ 08753-1866
Phone number: 732-255-4014
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