| NPI | 1659814853 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARNIE ANN FEGAN Clinical Psychologist/Supervisor 732-747-7765  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NJ 35SI00391500)  | 
| Enumeration Date | 2016-11-21 | 
| Last Update Date | 2016-11-21 |