Individual
DAI PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
615 N BROAD ST, ELIZABETH, NJ 07208-3409
(908) 355-7886
(908) 469-6520
Mailing address
615 N BROAD ST, ELIZABETH, NJ 07208-3409
(908) 355-7886
(908) 469-6520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL05403600
NJ
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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