Individual
MS. ANNE CATHERINE PORTINE- KUDLAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, RDT, LCADC, DRCC
Contact information
Practice address
19 EXCELSIOR PL, BUTLER, NJ 07405-1511
(973) 557-1545
Mailing address
19 EXCELSIOR PL, BUTLER, NJ 07405-1511
(973) 557-1545
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2035
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00121500
NJ
225800000X
Recreation Therapist
239
—
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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