Individual
ELIZABETH DAVIE VANDUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPS, ATR-BC, LPAT
Contact information
Practice address
550 W MAIN ST, BOONTON, NJ 07005-1168
(917) 710-2278
Mailing address
534 SUMMIT AVE, MAPLEWOOD, NJ 07040-1339
(917) 710-2278
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
16LP00009200
NJ
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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