Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 35S100350300 | NJ |
Y | 103T00000X | Psychologist | 35S100350300 | NJ |
NPI | 1003962390 |
---|---|
Provider Name | Sandra Ann Sessa |
First Address | Toms River, NJ 08753-7534 |
Second Address | Manasquan, NJ 08736-1918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2007 |
Last Update Date | 08/07/2007 |