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General NPI Number Information
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NPI Number | 1003642034
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Entity Type | Organization
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Legal Business Name | BREAKING ALL BARRIERS
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 23 WHEELER ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4603
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Country | US
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Telephone | 973-819-2033
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Fax |
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Provider Business Mailing Address
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Address Line | 23 WHEELER ST
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City | MONTCLAIR
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State | NJ
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Zip | 07042-4603
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Country | US
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Telephone | 973-819-2033
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | SHERELL BENDERS
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Credential | MA, ED
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Telephone | 973-819-2033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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