Organization
ARCHETYPE PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY WILSON-POTH PHD (OWNER)
(646) 820-5477
Entity
Organization
Contact information
Practice address
444 NORTHFIELD AVE, WEST ORANGE, NJ 07052-3012
(646) 820-5477
Mailing address
111 ALLEN ST, NETCONG, NJ 07857-1222
(973) 527-4464
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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