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General NPI Number Information
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NPI Number | 1306966767
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Entity Type | Individual
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Provider Name | THOMAS CHARLES DIPAOLA LICENSED CLINICAL SO
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Gender | Male
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 11/06/2008
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Provider Practice Location Address
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Address Line | 71 W MAIN ST SUITE 306
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City | FREEHOLD
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State | NJ
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Zip | 07728-2138
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Country | US
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Telephone | 609-731-0456
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Fax | 732-252-8612
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Provider Business Mailing Address
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Address Line | 71 W MAIN ST STE 306
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City | FREEHOLD
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State | NJ
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Zip | 07728-2139
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Country | US
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Telephone | 609-731-0456
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Fax | 732-252-8612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 44SC05274200
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License Number State | NJ
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