Individual
DR. JOAN ELLIS MYSIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
306 HALE STREET, PENNINGTON, NJ 08534-2705
(609) 818-9230
Mailing address
306 HALE STREET, PENNINGTON, NJ 08534
(609) 818-9230
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00254700
NJ
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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