Individual
MS. COLETTE BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
642 EAGLE ROCK AVE, SUITE 6, WEST ORANGE, NJ 07052-2954
(862) 704-6391
(862) 704-6392
Mailing address
185 EAST PALISADE AVENUE, A2B, ENGLEWOOD, NJ 07631-3151
(201) 819-1568
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL05773100
NJ
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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