Individual
JEDIEDJAH MOSHE RODRIGUES PEREIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1212 TODD CT, LAKEWOOD, NJ 08701-2256
(732) 814-4648
Mailing address
1212 TODD CT, LAKEWOOD, NJ 08701-2256
(732) 814-4648
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
37LC0021100
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05605500
NJ
Other
Enumeration date
03/04/2013
Last updated
06/16/2016
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