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General NPI Number Information
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NPI Number | 1053763375
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Entity Type | Organization
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Legal Business Name | OAK PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 19 SPEAR RD SUITE 201
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City | RAMSEY
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State | NJ
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Zip | 07446-1235
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Country | US
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Telephone | 201-961-3092
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Fax |
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Provider Business Mailing Address
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Address Line | 20 WALDMERE PL
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City | WALDWICK
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State | NJ
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Zip | 07463-1109
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Country | US
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Telephone | 201-961-3092
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ERIKA OAK
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Credential | PSY.D.
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Telephone | 201-961-3092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5556
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License Number State | NJ
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