Individual
BERNADETTE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 AIRPORT RD, LAKEWOOD, NJ 08701-5907
(732) 367-4700
Mailing address
1426 VALLEY DR, WALL TOWNSHIP, NJ 07719-4059
(201) 600-8954
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05507500
NJ
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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