Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
N | 101YP1600X | Pastoral Counselor | NJ |
NPI | 1245828763 |
---|---|
Provider Name | Natalie Adesanya |
First Address | Linden, NJ 07036-6167 |
Second Address | Linden, NJ 07036-6167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2021 |
Last Update Date | 10/01/2021 |