Individual
EDWIGE THEOKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4 W PARK ST STE 125, BORDENTOWN, NJ 08505-1352
(609) 817-4747
Mailing address
1 ANNA ROSE CT, BORDENTOWN, NJ 08505-2270
(917) 686-3898
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00631700
NJ
Other
Enumeration date
03/23/2019
Last updated
07/14/2022
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