Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 4734 | NJ |
NPI | 1205292190 |
---|---|
Provider Name | Dr. Karen Nancy Wasserman |
First Address | Livingston, NJ 07039 |
Second Address | Livingston, NJ 07039-1915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2016 |
Last Update Date | 07/01/2016 |