Individual
NICHOLAS DESISTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 HOPE RD STE 3B, EATONTOWN, NJ 07724-1273
(732) 724-1234
Mailing address
21 ALESSIO TER, HAMILTON, NJ 08620-9772
(609) 477-8557
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
NJ
Other
Enumeration date
11/07/2021
Last updated
11/07/2021
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