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Organization
MAPLE THERAPY CENTER LLC
Active
Organization
MAPLE THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN O PETERSON L.C.S.W. (LICENSED CLINICAL SOCIAL WORKER)
(201) 566-1535
Entity
Organization
Contact information
Practice address
65 N MAPLE AVE # 209, RIDGEWOOD, NJ 07450-3233
(201) 566-1535
Mailing address
65 N MAPLE AVE # 209, RIDGEWOOD, NJ 07450-3233
(201) 566-1535
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04898500
NJ
Other
Enumeration date
11/11/2009
Last updated
11/11/2009
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