Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 37AC00567200 | NJ |
Y | 101YM0800X | Mental Health Counselor | 37AC00567200 | NJ |
N | 101YS0200X | School Counselor | 37AC00567200 | NJ |
NPI | 1255099313 |
---|---|
Provider Name | Elena P Primost |
First Address | North Brunswick, NJ 08902-1212 |
Second Address | Skillman, NJ 08558-2019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2021 |
Last Update Date | 06/12/2021 |