Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 20748 | CA |
NPI | 1205394202 |
---|---|
Provider Name | Dr. Jillian Buchwald |
First Address | Short Hills, NJ 07078-0226 |
Second Address | New York, NY 10001-4509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2019 |
Last Update Date | 08/03/2019 |