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General NPI Number Information
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NPI Number | 1275831364
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTH COLLABORATIVE
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Dates
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Enumeration Date | 03/14/2011
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 716 BROAD ST
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City | CLIFTON
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State | NJ
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Zip | 07013-1645
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Country | US
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Telephone | 973-928-2912
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Fax | 973-928-2915
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Provider Business Mailing Address
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Address Line | 716 BROAD ST
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City | CLIFTON
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State | NJ
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Zip | 07013-1645
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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 | DIRECTOR
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Name | LONNIE MORRIS
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Credential | CNM, ND
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Telephone | 973-928-2912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 25ME00049201
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License Number State | NJ
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