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General NPI Number Information
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NPI Number | 1497529283
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Entity Type | Organization
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Legal Business Name | CANAVOSIO THERAPY LLC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 400 MAIN ST
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City | BEDMINSTER
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State | NJ
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Zip | 07921-2604
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Country | US
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Telephone | 908-370-9641
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Fax |
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Provider Business Mailing Address
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Address Line | 89 BEECHWOOD RD
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City | SUMMIT
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State | NJ
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Zip | 07901-2121
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Country | US
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Telephone | 908-370-9641
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROLINA CANAVOSIO
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Credential | LCSW
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Telephone | 908-370-9641
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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 |
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License Number State |
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