Individual
CLARENCIA SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2130 MILLBURN AVE, SUITE D1, MAPLEWOOD, NJ 07040-3725
(973) 763-8123
(973) 763-8243
Mailing address
2130 MILLBURN AVE, SUITE D1, MAPLEWOOD, NJ 07040-3725
(973) 763-8123
(973) 763-8243
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC01016900
NJ
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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