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Individual

TAYLOR SANSBURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
19-21 BELMONT AVE, DOVER, NJ 07801-4107
(971) 361-5555
Mailing address
19-21 BELMONT AVE, DOVER, NJ 07801-4107

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0356935
NJ
Enumeration date
02/04/2015
Last updated
02/04/2015
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