| NPI | 1558895003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN SUSAN BLOOM Owner 732-501-5917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05137300) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2018-03-02 |