| NPI | 1770031114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI R IPPOLITO Owner 973-667-6074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC00042000) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-12-27 |