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General NPI Number Information
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NPI Number | 1063939528
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Entity Type | Organization
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Legal Business Name | CHARTIER THERAPY GROUP
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Dates
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Enumeration Date | 08/25/2017
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Last Update Date | 08/25/2017
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Provider Practice Location Address
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Address Line | 350 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-0766
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Country | US
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Telephone | 201-675-3378
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Fax | 201-675-3378
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Provider Business Mailing Address
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Address Line | 350 W PASSAIC ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-3073
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Country | US
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Telephone | 201-675-3378
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TERAN CHARTIER
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Credential | LPC, ACS
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Telephone | 201-675-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37PC0024600
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License Number State | NJ
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