Organization
THE HUMAN GROWTH CENTER OF NEW JERSEY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONSTANTIN MOUHTIS PH.D. (CLINICAL DIRECTOR)
(973) 473-0800
Entity
Organization
Contact information
Practice address
1033 US HIGHWAY 46 STE 106, CLIFTON, NJ 07013-2448
(973) 473-0800
(973) 473-8058
Mailing address
1033 US HIGHWAY 46 STE 106, CLIFTON, NJ 07013-2448
(973) 473-0800
(973) 473-8058
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
SIO3346
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SIO3346
LICENSED PSYCHOLOGIST
NJ
Enumeration date
03/13/2007
Last updated
08/22/2020
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