Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC00396900 | NJ |
NPI | 1003049701 |
---|---|
Provider Name | Mr. Joshua P. Durand |
First Address | Haddon Heights, NJ 08035-1202 |
Second Address | Glassboro, NJ 08028-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2009 |
Last Update Date | 27/08/2009 |