Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05112400 | NJ |
NPI | 1003253626 |
---|---|
Provider Name | Angela Graceffo |
First Address | Clifton, NJ 07013-1009 |
Second Address | Clifton, NJ 07013-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 23/05/2013 |