Individual
GARY DRAKE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
99 BEAUVOIR AVE, SUMMIT, NJ 07901-3533
(973) 971-5595
Mailing address
PO BOX 23831, NEWARK, NJ 07189-0831
(973) 971-5595
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SC01495500
NJ
Other
Enumeration date
02/02/2006
Last updated
07/08/2007
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