Healthcare Provider Details

I. General information

NPI: 1093481426
Provider Name (Legal Business Name): LIFE & FAMILY GUIDANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 CLAFLIN AVE
EWING NJ
08638-2356
US

IV. Provider business mailing address

269 CLAFLIN AVE
EWING NJ
08638-2356
US

V. Phone/Fax

Practice location:
  • Phone: 609-429-0687
  • Fax:
Mailing address:
  • Phone: 609-508-3865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KATIE ONITIRI
Title or Position: OWNER
Credential: ED.S, LCADC, LMFT
Phone: 609-429-0687