Individual
LIBNA FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 BROAD ST, BLOOMFIELD, NJ 07003-2628
(973) 680-8600
Mailing address
480 CRESTWOOD AVE APT 35, HACKENSACK, NJ 07601-1423
(631) 991-5016
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06679400
NJ
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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