| NPI | 1629175708 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANGE PUIG Psychologist 856-482-7744  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35S100299200)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ 35S100180800)  | 
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NJ 35S100180800)  | |
| 103TC0700X Psychologist, Clinical (Licence: NJ 35S100180800)  | |
| 103TC1900X Psychologist, Counseling (Licence: NJ 35S100180800)  | |
| 103TS0200X Psychologist, School (Licence: NJ 35S100299200)  | |
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2020-04-14 |