Healthcare Provider Details

I. General information

NPI: 1285520395
Provider Name (Legal Business Name): MS. TINA D FLAX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 ROUTE 70 W STE 2
CHERRY HILL NJ
08002-3338
US

IV. Provider business mailing address

2230 RT 70 W STE 2 #1013
CHERRY HILL NJ
08002-3338
US

V. Phone/Fax

Practice location:
  • Phone: 908-758-3576
  • Fax: 888-253-3167
Mailing address:
  • Phone: 908-758-3576
  • Fax: 888-253-3167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: