| NPI | 1982185666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY NEAL Credentialing Specialist 908-304-8149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 44SC05742500) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |