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General NPI Number Information
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NPI Number | 1326466541
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Entity Type | Organization
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Legal Business Name | ACROSS THE BRIDGE
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Dates
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Enumeration Date | 04/03/2014
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 12 ROSZEL RD SUITE A 103
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City | PRINCETON
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State | NJ
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Zip | 08540-6234
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Country | US
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Telephone | 609-917-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 114 CLINTON ST
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City | LAMBERTVILLE
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State | NJ
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Zip | 08530-1911
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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 | OWNER
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Name | MRS. YUKO TANAKA INZANA
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Credential | LCSW
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Telephone | 609-917-4011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SC05369800
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License Number State | NJ
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