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Individual

DR. CHARLES P WAITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
639 STOKES RD, SUITE 203, MEDFORD, NJ 08055-3003
(609) 953-1222
(609) 714-0095
Mailing address
639 STOKES RD, SUITE 203, MEDFORD, NJ 08055-3003
(609) 953-1222
(609) 714-0095

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35SI00109300
NJ
103TC0700X
Clinical Psychologist
PS002060L
PA

Other

Enumeration date
09/29/2006
Last updated
07/08/2007
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