Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | 828559 | NJ |
NPI | 1043588338 |
---|---|
Provider Name | Miss Cassandra C Pestana |
First Address | Clark, NJ 07066-1877 |
Second Address | Clark, NJ 07066-1877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 01/12/2011 |