Healthcare Provider Details

I. General information

NPI: 1831729904
Provider Name (Legal Business Name): IDLER EDUCATIONAL TESTING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2020
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 MIMOSA DR
SEWELL NJ
08080-2804
US

IV. Provider business mailing address

109 MIMOSA DR
SEWELL NJ
08080-2804
US

V. Phone/Fax

Practice location:
  • Phone: 609-417-7745
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES JAMES IDLER JR.
Title or Position: SCHOOL PSYCHOLOGIST
Credential: ED.D.
Phone: 609-417-7745