Individual
MR. ROGER MAITLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD PSYCHOLOGY
Contact information
Practice address
999 RARITAN RD, CLARK, NJ 07066
(732) 381-6118
(732) 381-3491
Mailing address
PO BOX 885, CLARK, NJ 07066
(732) 381-6118
(732) 381-3491
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2387
NJ
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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