Healthcare Provider Details

I. General information

NPI: 1811330814
Provider Name (Legal Business Name): DAISY RIMLI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 SOUTH AVENUE EAST BUILDING A, 2ND FLOOR
CRANFORD NJ
07016
US

IV. Provider business mailing address

570 SOUTH AVENUE EAST BUILDING A, 2ND FLOOR
CRANFORD NJ
07016
US

V. Phone/Fax

Practice location:
  • Phone: 908-312-0587
  • Fax:
Mailing address:
  • Phone: 908-312-0587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05536500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: