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Individual

MS. ZASAH SUSSANNE KHADEMI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4 DAWES AVE, WEST ORANGE, NJ 07052-2317
(201) 618-8572
Mailing address
4 DAWES AVE, WEST ORANGE, NJ 07052-2317
(201) 618-8572

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
37PC00786900
NJ

Other

Enumeration date
09/20/2021
Last updated
09/20/2021
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