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Organization

DIVAD ZZEN THERAPY BOUTIQUE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIFFANY GILMORE PHD (CEO)
(856) 807-5363
Entity
Organization

Contact information

Practice address
321 YALE AVE STE B, STRATFORD, NJ 08084-1247
(856) 807-5363
Mailing address
321 JOHN F KENNEDY BLVD, LAWNSIDE, NJ 08045-1037
(856) 807-5316

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
08/04/2022
Last updated
09/17/2024
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