Individual
IRINA IVANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
4 ETHEL ROAD, SUITE 404, EDISON, NJ 08817
(732) 287-4044
(732) 287-0211
Mailing address
4 ETHEL ROAD, SUITE 404, EDISON, NJ 08817
(732) 287-4044
(732) 287-0211
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05223100
NJ
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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