Individual
TYISHIA DENISE JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
70 PARK ST STE 104, MONTCLAIR, NJ 07042-2960
(862) 234-5029
Mailing address
608 DUQUESNE TER, UNION, NJ 07083-9106
(347) 676-9962
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
44SL06812900
NJ
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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