Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC05759800 | NJ |
NPI | 1003243817 |
---|---|
Provider Name | Susan Hatami |
First Address | Neptune, NJ 07753 |
Second Address | Asbury Park, NJ 07712-5939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2013 |
Last Update Date | 22/01/2018 |