Individual
STEPHANIE SURGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1405 NJ 35, OCEAN, NJ 07712-0771
(732) 367-4700
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06583500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
08/11/2022
Last updated
08/11/2022
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