Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05697200 | NJ |
NPI | 1003219742 |
---|---|
Provider Name | Mrs. Sarah Mandel |
First Address | Mountainside, NJ 07092-2512 |
Second Address | Mountainside, NJ 07092-2512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2014 |
Last Update Date | 02/08/2016 |