Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 001428 | NY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 001428 | NY |
N | 103TC1900X | Counseling Psychologist | 001428 | NY |
N | 103TP0814X | Psychoanalysis | 001428 | NY |
N | 103TS0200X | School Psychologist | 001428 | NY |
NPI | 1366564601 |
---|---|
Provider Name | Dr. Mary Ellen M Stiehl |
First Address | Allendale, NJ 07401 |
Second Address | Allendale, NJ 07401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 30/08/2007 |