Individual
EDWARD BANASIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
570 LEE ST, PERTH AMBOY, NJ 08861-3053
(732) 442-1666
Mailing address
166 WILD DUNES WAY, JACKSON, NJ 08527-4051
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00189600
NJ
Other
Enumeration date
05/22/2007
Last updated
03/04/2010
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