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General NPI Number Information
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NPI Number | 1679548192
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Entity Type | Individual
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Provider Name | JULIE ROCKWOOD ZAKRESKI PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 272 BROAD ST
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City | RED BANK
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State | NJ
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Zip | 07701-2003
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Country | US
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Telephone | 732-741-0456
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Fax | 732-219-9477
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Provider Business Mailing Address
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Address Line | 40 AVENUE AT THE CMN SUITE 203
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4800
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Country | US
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Telephone | 732-544-9079
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Fax | 732-544-9079
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 2152
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License Number State | NJ
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