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Individual

MS. CAROL DIANE CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
33 S 4TH AVE, HIGHLAND PARK, NJ 08904-2620
(732) 745-2662
Mailing address
227 VALENTINE ST, HIGHLAND PARK, NJ 08904-2204
(732) 745-2662
(732) 572-1753

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00177200
NJ

Other

Enumeration date
01/19/2007
Last updated
07/08/2007
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