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General NPI Number Information
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NPI Number | 1033028295
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Entity Type | Individual
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Provider Name | NANCY TLATENCO
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 1300 MAIN AVE APT 2D
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City | CLIFTON
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State | NJ
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Zip | 07011-2266
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Country | US
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Telephone | 201-665-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 201 TALMAGE AVE APT 2
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City | BOUND BROOK
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State | NJ
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Zip | 08805-2245
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FA00068800
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License Number State | NJ
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