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General NPI Number Information
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NPI Number | 1184171464
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Entity Type | Organization
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Legal Business Name | ELLEN M HERR-ISRAEL PH D LLC
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Dates
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Enumeration Date | 09/05/2016
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 166 BUNN DR STE 102
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City | PRINCETON
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State | NJ
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Zip | 08540-2800
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Country | US
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Telephone | 908-625-1534
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Fax |
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Provider Business Mailing Address
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Address Line | 166 BUNN DR STE 102
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City | PRINCETON
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State | NJ
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Zip | 08540-2800
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Country | US
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Telephone | 908-625-1534
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | ELLEN HERR-ISRAEL
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Credential |
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Telephone | 908-625-1534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 35SI00563100
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License Number State | NJ
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