Individual
CORY BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
120 CHESTNUT ST, RIDGEWOOD, NJ 07450-2504
(201) 444-3565
Mailing address
33 MANCHESTER AVE, NORTH HALEDON, NJ 07508-2609
(973) 615-6899
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00509500
NJ
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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