Individual
DESTINY SHARACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22 VILLAGE CT, HAZLET, NJ 07730-1532
(732) 440-9141
Mailing address
22 VILLAGE CT, HAZLET, NJ 07730-1532
(732) 440-9141
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SL06320100
NJ
1041C0700X
Clinical Social Worker
Primary
44SC06040800
NJ
Other
Enumeration date
04/12/2021
Last updated
05/12/2022
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