Individual
SARA LOESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
162 MAPLE PL, KEYPORT, NJ 07735-1346
(732) 978-3128
Mailing address
162 MAPLE PL, KEYPORT, NJ 07735-1346
(732) 978-3128
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
098307
NY
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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