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General NPI Number Information
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NPI Number | 1275965360
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Entity Type | Organization
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Legal Business Name | DBT LIFESKILLS, LLC
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 07/31/2013
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Provider Practice Location Address
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Address Line | 40 AIRPORT RD
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City | LAKEWOOD
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State | NJ
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Zip | 08701-7032
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Country | US
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Telephone | 732-363-6595
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Fax |
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Provider Business Mailing Address
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Address Line | 206 HADASSAH LN
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5563
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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 | BLANCA KLEIN
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Credential |
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Telephone | 732-616-0581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05466200
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License Number State | NJ
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