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Individual

NICOLE REBECCA AMOYAL-PENSAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
210 BROAD ST, RED BANK, NJ 07701-2060
(609) 283-2056
Mailing address
145 MONMOUTH ST, RED BANK, NJ 07701-1237

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35SI00568900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1487094959
OUT OF NETWORK
NJ
Enumeration date
06/28/2013
Last updated
02/13/2019
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