Individual
DR. LORI TANNENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
147 BROAD ST, SUMMIT, NJ 07901-5915
(908) 273-1324
Mailing address
147 BROAD ST, SUMMIT, NJ 07901-5915
(908) 273-1324
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017780
NY
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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