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General NPI Number Information
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NPI Number | 1477956837
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Entity Type | Organization
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Legal Business Name | FARIFIELD TOWNSHIP SCHOOL
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 375 GOULDTOWN WOODRUFF RD
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City | BRIDGETON
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State | NJ
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Zip | 08302-7242
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Country | US
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Telephone | 856-453-1882
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Fax | 856-453-7189
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Provider Business Mailing Address
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Address Line | 375 GOULDTOWN WOODRUFF RD
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City | BRIDGETON
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State | NJ
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Zip | 08302-7242
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Country | US
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Telephone | 856-453-1882
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Fax | 856-453-7189
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Authorized Official
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Title or Position | BA
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Name | MR. RICHARD DAVIDSON
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Credential |
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Telephone | 856-453-1882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 538341
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00518300
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00264300
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 89331
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 40611
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License Number State | NJ
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