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Individual

SANDRA D IVEY-PRUSINOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2040 MILLBURN AVE STE 205, MAPLEWOOD, NJ 07040-3716
(201) 207-7268
(973) 761-7214
Mailing address
2040 MILLBURN AVE STE 205, MAPLEWOOD, NJ 07040-3716
(201) 207-7268
(973) 761-7214

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05548300
NJ

Other

Enumeration date
04/24/2012
Last updated
06/29/2016
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