Organization
BERGEN PSYCHOTHERAPY & COMMUNITY OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALIDA A. DOMINIANNI LCSW (DIRECTOR)
(201) 833-8838
Entity
Organization
Contact information
Practice address
901 TEANECK RD, TEANECK, NJ 07666-4511
(201) 357-2714
Mailing address
901 TEANECK RD, TEANECK, NJ 07666-4511
(201) 357-2714
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05249200
NJ
1041C0700X
Clinical Social Worker
44SC05322900
NJ
Other
Enumeration date
03/09/2008
Last updated
03/09/2008
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