| NPI | 1629485792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY WILSON Manager/Clinician 862-485-7941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SL05582700) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |