Individual
MIRA DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
233 MOUNT AIRY RD, BASKING RIDGE, NJ 07920-2338
(917) 533-5871
Mailing address
64 CONKLING ST, BASKING RIDGE, NJ 07920-1715
(917) 533-5871
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00816800
NJ
Other
Enumeration date
11/16/2021
Last updated
01/21/2022
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