Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003247834 |
---|---|
Provider Name | Grishma Mehta |
First Address | Mount Laurel, NJ 08054-6828 |
Second Address | Trenton, NJ 08618-3968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2013 |
Last Update Date | 04/12/2013 |