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Individual

EMMETT CHARLES LINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
37 BROOKSIDE AVE, DEMAREST, NJ 07627-2005
(608) 516-6074
Mailing address
37 BROOKSIDE AVE, DEMAREST, NJ 07627-2005

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00559100
NJ

Other

Enumeration date
01/30/2025
Last updated
01/30/2025
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