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Individual

CORINNE CECILE DATCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, ABPP

Contact information

Practice address
35 DEFOREST AVE, SUMMIT, NJ 07901-2155
(812) 360-5143
Mailing address
1480 PLEASANT VALLEY WAY, UNIT 15, WEST ORANGE, NJ 07052-1300
(812) 360-5143

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00535000
NJ
103TF0000X
Family Psychologist
ABPP # 7521

Other

Enumeration date
07/04/2015
Last updated
07/04/2015
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