Individual
KAITLIN E DEITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
80 CONOVER RD, MARLBORO, NJ 07746-1003
(732) 946-9444
Mailing address
PO BOX 177, MARLBORO, NJ 07746-0177
(732) 946-9444
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00278300
NJ
Other
Enumeration date
05/22/2019
Last updated
05/22/2019
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