Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 207QA0401X | Family Doctor - Addiction Medicine | 25MB09077400 | NJ |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NO10537200 | NJ |
NPI | 1710519970 |
---|---|
Provider Name | Robert Laguarina JR. |
First Address | Woodbury Heights, NJ 08097-1026 |
Second Address | Woodbury Heights, NJ 08097-1026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2020 |
Last Update Date | 06/02/2020 |