Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC00808400 | NJ |
NPI | 1003577990 |
---|---|
Provider Name | Sarah Trengove |
First Address | Palisades Park, NJ 07650-2986 |
Second Address | Hang Dong, CHIANG MAI 50230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2022 |
Last Update Date | 04/01/2022 |