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General NPI Number Information
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NPI Number | 1659622637
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Entity Type | Organization
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Legal Business Name | DEBORAH SACKS, PH.D.
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 10/01/2012
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Provider Practice Location Address
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Address Line | 10 E MOUNT VERNON AVE
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2325
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Country | US
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Telephone | 856-816-0048
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Fax | 856-354-0681
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Provider Business Mailing Address
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Address Line | 10 E MOUNT VERNON AVE
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2325
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Country | US
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Telephone | 856-816-0048
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Fax | 856-354-0681
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DEBORAH SACKS
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Credential | PH.D.
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Telephone | 856-816-0048
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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 | 35SI00230800
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License Number State | NJ
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