Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 5903 | NJ |
Y | 103T00000X | Psychologist | 5903 | NJ |
NPI | 1013419233 |
---|---|
Provider Name | Dr. Beth Barbarasch |
First Address | Montclair, NJ 07042-3245 |
Second Address | Verona, NJ 07044-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2018 |
Last Update Date | 03/03/2018 |