Individual
KIM LEE HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
1901 HWY 71 STE 3C, WALL TOWNSHIP, NJ 07719-3278
(732) 556-6290
(732) 556-6015
Mailing address
1901 HWY 71 STE 3C, WALL TOWNSHIP, NJ 07719-3278
(732) 556-6290
(732) 556-6015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
37LC00173200
NJ
101YP2500X
Professional Counselor
Primary
37PC00459300
NJ
Other
Enumeration date
04/08/2011
Last updated
12/06/2012
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