Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4998 | NJ |
NPI | 1083044374 |
---|---|
Provider Name | Dr. Lisa Weinberg |
First Address | Maplewood, NJ 07040-3409 |
Second Address | Montclair, NJ 07042-2211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2013 |
Last Update Date | 22/11/2013 |