Individual
SHANICE N BURGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
75 ESSEX ST STE 110, HACKENSACK, NJ 07601-4034
(201) 488-6678
Mailing address
PO BOX 3016, SOUTH HACKENSACK, NJ 07606-1016
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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