Individual
MS. LIA HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
11 PATERSON AVE, MIDLAND PARK, NJ 07432-1829
(201) 321-4071
Mailing address
11 PATERSON AVE, SUITE 4, MIDLAND PARK, NJ 07432-1829
(201) 321-4071
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00377100
NJ
Other
Enumeration date
05/17/2012
Last updated
05/17/2012
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