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Organization

ROANOKE PSYCHOLOGICAL SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MICHELE GARNER LCSW (DIRECTOR)
(646) 942-6852
Entity
Organization

Contact information

Practice address
71 SOUTH ORANGE AVE, SUITE 350, SOUTH ORANGE, NJ 07079
(646) 942-6852
(718) 761-3094
Mailing address
71 SOUTH ORANGE AVE, SUITE 350, SOUTH ORANGE, NJ 07079
(646) 942-6852
(718) 761-3094

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3177
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7218907
NJ
Enumeration date
10/11/2006
Last updated
03/12/2008
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