Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4682 | NJ |
NPI | 1114237484 |
---|---|
Provider Name | Dr. Erika January |
First Address | Summit, NJ 07901 |
Second Address | Summit, NJ 07901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 02/08/2011 |