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General NPI Number Information
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NPI Number | 1568592608
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Entity Type | Individual
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Provider Name | NOURIMAN - GHAHARY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 103 PARK ST SUITE 2A
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City | MONTCLAIR
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State | NJ
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Zip | 07042-5913
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Country | US
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Telephone | 201-956-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 565 GROVE ST APT. F13
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City | CLIFTON
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State | NJ
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Zip | 07013-3142
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Country | US
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Telephone | 973-471-4246
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 4404
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License Number State | NJ
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