Individual
DEBORAH R. KOURGELIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
163 DAYTON ST, RIDGEWOOD, NJ 07450-4407
(201) 694-1648
Mailing address
115 FRANKLIN TPKE # 198, MAHWAH, NJ 07430-1325
(201) 529-3531
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05300400
NJ
Other
Enumeration date
04/10/2009
Last updated
04/10/2009
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