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General NPI Number Information
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NPI Number | 1003331315
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PSYCHOLOGY ASSOCIATES OF SOUTH JERSEY , LLC
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Dates
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Enumeration Date | 08/08/2017
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 123 EGG HARBOR RD STE 302
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City | SEWELL
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State | NJ
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Zip | 08080-9406
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Country | US
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Telephone | 856-278-6095
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Fax |
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Provider Business Mailing Address
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Address Line | 719 CLARK DR
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City | MULLICA HILL
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State | NJ
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Zip | 08062-1839
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Country | US
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Telephone | 856-631-6534
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KAREN ALBERTS SAPORITO
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Credential | PH.D.
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Telephone | 856-631-6534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 35SI00426200
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00426200
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License Number State | NJ
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