Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 6496 | NJ |
NPI | 1124797527 |
---|---|
Provider Name | Dr. Cara Genbauffe |
First Address | Cherry Hill, NJ 08003-2123 |
Second Address | Cherry Hill, NJ 08003-2123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2021 |
Last Update Date | 09/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6496 | NJ PSYCHOLOGY LICENSE NUMBER (01) | NJ |