Healthcare Provider Details

I. General information

NPI: 1700900453
Provider Name (Legal Business Name): ANTONIA FLINT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 STOCKTON ST
PRINCETON NJ
08540-6813
US

IV. Provider business mailing address

203 SALEM CT APT 8
PRINCETON NJ
08540-7041
US

V. Phone/Fax

Practice location:
  • Phone: 609-924-0060
  • Fax: 609-924-7436
Mailing address:
  • Phone: 609-356-0029
  • Fax: 609-356-0031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00594400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: