Organization
INTERVAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN PERERA LCSW (MEMBER)
(973) 337-0586
Entity
Organization
Contact information
Practice address
476 SOUTH AVE E, CRANFORD, NJ 07016-3204
(973) 337-0586
Mailing address
PO BOX 14, SUMMIT, NJ 07902-0014
(973) 337-0586
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05720200
NJ
Other
Enumeration date
05/14/2018
Last updated
03/29/2019
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