Individual
ADIA J TERRY-PURYEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7289
Mailing address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-7289
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
44SC05860600
NJ
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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