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General NPI Number Information
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NPI Number | 1366085565
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Entity Type | Individual
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Provider Name | JILL O'HARE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 10/21/2019
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Last Update Date | 10/21/2019
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Provider Practice Location Address
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Address Line | 70 S MAIN ST STE 1A
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City | CRANBURY
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State | NJ
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Zip | 08512-3140
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Country | US
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Telephone | 609-217-0973
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Fax |
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Provider Business Mailing Address
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Address Line | 76 CYPRESS DR
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City | EAST WINDSOR
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State | NJ
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Zip | 08520-2320
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Country | US
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Telephone | 732-690-6595
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35SI00618200
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License Number State | NJ
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