Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 37PC00636800 | NJ |
NPI | 1023594595 |
---|---|
Provider Name | Nuha M Matari |
First Address | Wayne, NJ 07470-8506 |
Second Address | Wayne, NJ 07470-8506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2018 |
Last Update Date | 17/07/2018 |