Individual
MIRA CHAMPANERIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
67 LAKEWOOD AVE, CEDAR GROVE, NJ 07009-1507
(973) 699-1013
Mailing address
67 LAKEWOOD AVE, CEDAR GROVE, NJ 07009-1507
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37PC01201700
NJ
Other
Enumeration date
12/23/2025
Last updated
12/23/2025
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