Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
Y | 1041C0700X | Clinical Social Worker | 44SC01299200 | NJ |
NPI | 1093045213 |
---|---|
Provider Name | Ms. Patricia Gale Vadine |
First Address | River Vale, NJ 07675 |
Second Address | River Vale, NJ 07675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2010 |
Last Update Date | 22/12/2014 |