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General NPI Number Information
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NPI Number | 1609285188
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Entity Type | Individual
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Provider Name | LAURA BERNESS PHD
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Gender | Female
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 122 COMMONS WAY
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City | PRINCETON
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State | NJ
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Zip | 08540-1507
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Country | US
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Telephone | 908-907-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 122 COMMONS WAY
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City | PRINCETON
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State | NJ
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Zip | 08540-1507
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Country | US
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Telephone | 908-907-0693
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35S100505700
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License Number State | NJ
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