| NPI | 1881235497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL E. PORTMAN Clinical Social Worker (Licensed In 201-321-4334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2019-10-04 |