Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 37LC00295500 | NJ |
Y | 1041C0700X | Clinical Social Worker | 44SC05767700 | NJ |
N | 1041S0200X | School Social Worker | 1127185 | NJ |
NPI | 1003320094 |
---|---|
Provider Name | Ms. Nina Kamelia |
First Address | Collingswood, NJ 08108-2070 |
Second Address | Collingswood, NJ 08108-2070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 15/01/2021 |