Individual
MR. DOMINICK ANTHONY DEBLASIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC LCADC
Contact information
Practice address
201 LINCOLN AVE E, CRANFORD, NJ 07016-2909
(908) 276-0590
Mailing address
841 HUNTINGTON AVE, PINE BEACH, NJ 08741-1311
(732) 773-5431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00101900
NJ
101YM0800X
Mental Health Counselor
Primary
37PC00119700
NJ
Other
Enumeration date
06/06/2008
Last updated
06/06/2008
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