Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05405500 | NJ |
NPI | 1003143702 |
---|---|
Provider Name | Bernadette Purcell Amato |
First Address | Avon By The Sea, NJ 07717-1147 |
Second Address | Avon By The Sea, NJ 07717-1147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2009 |
Last Update Date | 17/11/2009 |