Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37AC00111900 | NJ |
NPI | 1003177254 |
---|---|
Provider Name | Mrs. Dominika Lewandowska |
First Address | East Brunswick, NJ 08816-5699 |
Second Address | East Brunswick, NJ 08816-5699 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 05/06/2012 |