Organization
TIMOTHY FAITH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA MAE NIELSEN LPC, NCC, MC (DIRECTOR)
(609) 970-4680
Entity
Organization
Contact information
Practice address
101 STONEHAM DR, GLASSBORO, NJ 08028-3001
(609) 970-4680
Mailing address
101 STONEHAM DR, GLASSBORO, NJ 08028-3001
(609) 970-4680
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00250000
NJ
251S00000X
Community/Behavioral Health Agency
37PC00250000
NJ
302F00000X
Exclusive Provider Organization
37PC00250000
NJ
305R00000X
Preferred Provider Organization
37PC00250000
NJ
Other
Enumeration date
01/25/2009
Last updated
01/25/2009
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