Healthcare Provider Details
I. General information
NPI: 1255251377
Provider Name (Legal Business Name): THERAPEUTIC SELF CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
329 E JIMMIE LEEDS RD STE 101
GALLOWAY NJ
08205-4110
US
IV. Provider business mailing address
329 E JIMMIE LEEDS RD STE 101
GALLOWAY NJ
08205-4110
US
V. Phone/Fax
- Phone: 609-241-0234
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GABRIELA
CATALINA
LOPEZ
Title or Position: OWNER
Credential:
Phone: 609-328-0775