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Individual

IRINA IVANOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13-20 RIVER RD # R, FAIR LAWN, NJ 07410-1847
(201) 466-2725
Mailing address
13-20 RIVER RD # R, FAIR LAWN, NJ 07410-1847

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL07127800
NJ

Other

Enumeration date
09/23/2024
Last updated
09/23/2024
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