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Individual

EMMANUEL V REGISTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, LCADC

Contact information

Practice address
893 BROADWAY STE 736, BAYONNE, NJ 07002-3053
(201) 858-1119
Mailing address
PO BOX 736, BAYONNE, NJ 07002-0736
(201) 858-1119

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL0588650
NJ

Other

Enumeration date
08/24/2016
Last updated
12/01/2022
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