Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC00282600 | NJ |
NPI | 1003029067 |
---|---|
Provider Name | Paula Freed |
First Address | Oceanport, NJ 07757-1030 |
Second Address | Oceanport, NJ 07757-1030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |