Individual
DR. DEBRA BASHIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10 MINELL PL, TEANECK, NJ 07666-5508
(646) 671-6239
Mailing address
668 PASSAIC AVE, CLIFTON, NJ 07012-1827
(646) 671-6239
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
35SI00511300
NJ
103TC0700X
Clinical Psychologist
Primary
35SI00511300
NJ
Other
Enumeration date
11/07/2013
Last updated
12/29/2020
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