Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3455 | NJ |
Y | 103TC0700X | Clinical Psychologist | 3455 | NJ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3455 | NJ |
NPI | 1063573756 |
---|---|
Provider Name | Dr. Denise Ann Deluca |
First Address | Boonton, NJ 07005-1635 |
Second Address | Pine Brook, NJ 07058-9576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 05/01/2015 |