Individual
TASIA C FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 BEDFORD ST, EAST ORANGE, NJ 07018-1841
(973) 874-3169
Mailing address
45 BEDFORD ST, EAST ORANGE, NJ 07018-1841
(973) 874-3169
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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