Organization
ICDL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY GUENZEL (CEO)
(973) 797-9680
Entity
Organization
Contact information
Practice address
999 RIVERVIEW DR STE 201, TOTOWA, NJ 07512-1165
(973) 797-9680
Mailing address
999 RIVERVIEW DR STE 201, TOTOWA, NJ 07512-1165
(973) 797-9680
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/26/2018
Last updated
09/01/2019
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