Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | NJ |
NPI | 1003307083 |
---|---|
Provider Name | Amanda Silverblatt |
First Address | Allentown, NJ 08501-1949 |
Second Address | Manalapan, NJ 07726-8736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2018 |
Last Update Date | 24/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
462376893 | 1093058547 (01) | NJ |