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Organization

MENDING WINGS TO SOAR

Active
Other names
Mending Wings To Soar
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MOYA MATHISON LPC (OWNER/THERAPIST)
(973) 937-8632
Entity
Organization

Contact information

Practice address
460 BLOOMFIELD AVE, MONTCLAIR, NJ 07042-3582
(973) 937-8632
Mailing address
460 BLOOMFIELD AVE, MONTCLAIR, NJ 07042-3582
(973) 937-8632

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
37PC00559100
NJ

Other

Enumeration date
01/22/2018
Last updated
01/22/2018
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