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Individual

DR. JEREMY LICHTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D

Contact information

Practice address
2 TOWER CENTER BLVD, SUITE 1943, EAST BRUNSWICK, NJ 08816-1100
(732) 788-6009
Mailing address
2 TOWER CENTER BLVD, SUITE 1943, EAST BRUNSWICK, NJ 08816-1100
(732) 788-6009

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
TP# 163-066
NJ
103TS0200X
School Psychologist
989192
NJ

Other

Enumeration date
12/09/2016
Last updated
12/09/2016
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