Individual
MR. MICHAEL OUTWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3040 KENNEDY BLVD, JERSEY CITY, NJ 07306
(201) 798-9924
Mailing address
505A MANILA AVE, JERSEY CITY, NJ 07302-1723
(201) 659-5299
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00183400
NJ
Other
Enumeration date
02/09/2007
Last updated
07/08/2007
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