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General NPI Number Information
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NPI Number | 1104111095
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Entity Type | Organization
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Legal Business Name | MULTICULTURAL COUNSELING AND TESTING CENTER
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Dates
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Enumeration Date | 06/19/2011
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Last Update Date | 06/19/2011
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Provider Practice Location Address
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Address Line | 893 WESTFIELD AVE
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City | ELIZABETH
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State | NJ
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Zip | 07208-1258
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Country | US
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Telephone | 973-652-2753
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Fax | 908-998-1605
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Provider Business Mailing Address
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Address Line | 893 WESTFIELD AVE
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City | ELIZABETH
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State | NJ
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Zip | 07208-1258
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Country | US
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Telephone | 973-652-2753
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Fax | 908-998-1605
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Authorized Official
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Title or Position | OWNER
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Name | DR. GHISLENE MEANCE
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Credential | PSY.D
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Telephone | 973-652-2753
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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 | 4566
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License Number State | NJ
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