MEDICARE: RELIANT FORENSIC SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TF0200X	Forensic Psychologist

General Provider Information

NPI Number	:	1295394062
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIANT FORENSIC SERVICES

Provider Business Mailing Address
First Line	:	266 HARRISTOWN RD STE 209
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-3321
Country	:	US
Telephone Number	:	201-564-7331
Fax Number	:

Provider Business Practice Location Address
First Line	:	266 HARRISTOWN RD STE 209
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-3321
Country	:	US
Telephone Number	:	201-345-1695
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	KAREN M RULE
Credential	:	LCSW
Telephone Number	:	201-345-1695

Provider Enumeration Date	:	06/06/2019
Last Update Date	:	06/07/2019

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