Organization
KITCHEN TABLE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE W MASON-REESE (HEALTHCARE PROVIDER)
(201) 725-1807
Entity
Organization
Contact information
Practice address
31 NEWFIELD STREET, EAST ORANGE, NJ 07017-5410
(201) 725-1807
Mailing address
31 NEWFIELD STREET, EAST ORANGE, NJ 07017-5410
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC00586800
NJ
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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