Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003161043 |
---|---|
Provider Name | Ms. Denise Rue |
First Address | Perth Amboy, NJ 08861-3053 |
Second Address | Perth Amboy, NJ 08861-3053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 16/07/2012 |