Individual
HEATHER TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37 EVERGREEN PL, EAST ORANGE, NJ 07018-2154
(973) 266-7983
Mailing address
590 N 7TH ST, NEWARK, NJ 07107-2522
(973) 596-5101
(973) 639-5049
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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