Individual
DENISE WALLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
470 FOREST ST, UNIT 2, KEARNY, NJ 07032-3582
(973) 715-7593
Mailing address
470 FOREST ST, UNIT 2, KEARNY, NJ 07032-3582
(973) 715-7593
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
35SI00558100
NJ
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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