Individual
SUSANNE PITAK DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC 01178
Contact information
Practice address
8 GRANT AVE, LAMBERTVILLE, NJ 08530-2304
(609) 947-3057
Mailing address
8 GRANT AVE, LAMBERTVILLE, NJ 08530-2304
(609) 947-3057
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37PC001178000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01178
BEHAVIORAL BOARD OF EXAMINERS
NJ
Enumeration date
01/08/2019
Last updated
01/08/2019
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