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Individual

DR. ILANA TANNENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
31 S FULLERTON AVE, 2ND FLOOR, MONTCLAIR, NJ 07042-3455
(973) 744-4494
Mailing address
296 BERKELEY AVE, BLOOMFIELD, NJ 07003-4946

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
35SI00470500
NJ
103TC1900X
Counseling Psychologist
Primary
35SI00470500
NJ

Other

Enumeration date
03/31/2010
Last updated
03/31/2010
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