Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05515700 | NJ |
NPI | 1003072836 |
---|---|
Provider Name | Ms. Dina P Brue |
First Address | Scotch Plains, NJ 07076-4626 |
Second Address | Scotch Plains, NJ 07076-1767 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2008 |
Last Update Date | 14/01/2013 |