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Organization
MINDFUL THERAPY OF MONMOUTH COUNTY LLC
Active
Organization
MINDFUL THERAPY OF MONMOUTH COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE RACHEL WEGWEISER LCSW (OWNER)
(732) 705-1561
Entity
Organization
Contact information
Practice address
30 FRENEAU AVE BLDG A, MATAWAN, NJ 07747-3390
(732) 705-1561
(732) 791-9057
Mailing address
30 FRENEAU AVE BLDG A, MATAWAN, NJ 07747-3390
(732) 705-1561
(732) 791-9057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215185004
NPI
NJ
Enumeration date
04/23/2021
Last updated
04/23/2021
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