Individual
ILONSKA ANATAVEL RIVAS PRANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4130 BERGEN TPKE APT 1, NORTH BERGEN, NJ 07047-2510
(201) 993-5813
Mailing address
4130 BERGEN TPKE APT 1, NORTH BERGEN, NJ 07047-2510
(201) 993-5813
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00789100
NJ
Other
Enumeration date
06/14/2024
Last updated
06/14/2024
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