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General NPI Number Information
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NPI Number | 1437861069
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Entity Type | Organization
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Legal Business Name | YOUR PATH TO GROW LLC
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Dates
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Enumeration Date | 12/14/2022
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 134 HICKORY AVE
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City | TENAFLY
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State | NJ
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Zip | 07670-1512
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Country | US
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Telephone | 215-789-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 265 HACKENSACK ST UNIT 1212
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-1253
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Country | US
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Telephone | 215-789-5002
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | ANATH NEVO
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Credential |
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Telephone | 201-644-6424
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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 |
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License Number State |
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