Organization
ARIADNES THREAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VALERY FRADKOV LCSW (CLINICAL DIRECTOR)
(201) 497-0289
Entity
Organization
Contact information
Practice address
46 BERGEN ST, ENGLEWOOD, NJ 07631-2908
(201) 336-4244
Mailing address
46 BERGEN ST, ENGLEWOOD, NJ 07631-2908
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05391100
NJ
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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