Individual
CARISSA BAVOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
905 ABBY RD, MIDDLETOWN, NJ 07748-6504
(908) 692-6698
Mailing address
905 ABBY RD, MIDDLETOWN, NJ 07748-6504
(908) 692-6698
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05493600
NJ
1041S0200X
School Social Worker
563303
NJ
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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