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General NPI Number Information
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NPI Number | 1700929684
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Entity Type | Organization
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Legal Business Name | JEAN GREENWALD
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 43 UNIONVILLE AVE
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City | SUSSEX
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State | NJ
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Zip | 07461-2130
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Country | US
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Telephone | 973-875-4747
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Fax | 973-875-9597
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Provider Business Mailing Address
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Address Line | 43 UNIONVILLE AVE
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City | SUSSEX
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State | NJ
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Zip | 07461-2130
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Country | US
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Telephone | 973-875-4747
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Fax | 973-875-9597
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Authorized Official
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Title or Position | FOUNDER
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Name | MS. JEAN GREENWALD
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Credential | M.A., ED.S.
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Telephone | 973-875-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37F100120600
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License Number State | NJ
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