Healthcare Provider Details

I. General information

NPI: 1982956132
Provider Name (Legal Business Name): ALLISON J SHALE DEUTSCH PSYCHOLOGIST (PSY.D)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 E ALLENDALE RD STE 2B
SADDLE RIVER NJ
07458-3057
US

IV. Provider business mailing address

82 E ALLENDALE RD STE 2B
SADDLE RIVER NJ
07458-3057
US

V. Phone/Fax

Practice location:
  • Phone: 201-477-8178
  • Fax:
Mailing address:
  • Phone: 201-477-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5389
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: