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Individual

ELISA SHAWN MILLER BRUCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
205 N FRANKLIN TPKE, RAMSEY, NJ 07446-1630
(201) 321-2956
Mailing address
16 PELZ FARM CT, MAHWAH, NJ 07430-3275
(201) 321-2956
(201) 321-2956

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC46893
NJ

Other

Enumeration date
08/11/2006
Last updated
03/21/2017
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