| NPI | 1609380013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOHANNY C VALDERRAMA Licensed Clinical Social Worker 201-562-8931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: NJ 44SC05657400) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-12-19 |