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General NPI Number Information
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NPI Number | 1528448321
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Entity Type | Individual
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Provider Name | WANDA Y QUEZADA ED. D
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Gender | Female
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 322 LIVINGSTON AVE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901
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Country | US
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Telephone | 732-202-5406
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Fax | 732-543-0602
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Provider Business Mailing Address
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Address Line | 335 GEORGE STREET SUITE 4 #307
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-3457
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Country | US
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Telephone | 908-358-5068
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Fax | 908-312-5076
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | NJ
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