Individual
SOO EO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7 BROAD AVE STE 206, PALISADES PARK, NJ 07650-1886
(201) 313-0131
Mailing address
7 BROAD AVE STE 206, PALISADES PARK, NJ 07650-1886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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