Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 35S100417200 | NJ |
NPI | 1073677787 |
---|---|
Provider Name | Christina Treutler |
First Address | Cherry Hill, NJ 08003-3214 |
Second Address | Marlton, NJ 08053-2341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0051721 | (05) | NJ |
Q29397 | (02) |