Individual
KENNETH HART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LAC
Contact information
Practice address
530 MAIN AVE, PASSAIC, NJ 07055-5700
(973) 470-3142
Mailing address
530 MAIN AVE, PASSAIC, NJ 07055-5700
(973) 470-3142
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00111400
NJ
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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