Individual
MS. NICOLETTE ROSE TAKACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
35 BEAVERSON BLVD, BRICK, NJ 08723-7812
(732) 966-4166
Mailing address
35 BEAVERSON BLVD, BRICK, NJ 08723-7812
(732) 966-4166
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC01137400
NJ
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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