Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05843800 | NJ |
NPI | 1003230392 |
---|---|
Provider Name | Ms. Yudelka Columna-Grajewski |
First Address | Andover, NJ 07821-5503 |
Second Address | Hackettstown, NJ 07840-2300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2014 |
Last Update Date | 04/11/2019 |