Individual
DAVIS TANNENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1771 MADISON AVE, LAKEWOOD, NJ 08701-1242
(732) 364-2144
Mailing address
958 CLAIRE DR, LAKEWOOD, NJ 08701-5517
(718) 288-8354
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05903600
NJ
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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