Individual
MS. GAIL DERIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
207 BELLEVUE AVE, MONTCLAIR, NJ 07043-1884
(862) 596-7816
Mailing address
29 FREDERICK ST, MONTCLAIR, NJ 07042-4105
(973) 746-5758
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC01294900
NJ
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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