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General NPI Number Information
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NPI Number | 1780141671
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Entity Type | Organization
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Legal Business Name | PATHWAY TO CENTER, LLC
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 76 SCHRAALENBURG RD STE 5
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City | HARRINGTON PARK
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State | NJ
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Zip | 07640-1935
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Country | US
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Telephone | 201-467-8489
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Fax | 201-564-7532
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Provider Business Mailing Address
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Address Line | 76 SCHRAALENBURG RD STE 5
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City | HARRINGTON PARK
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State | NJ
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Zip | 07640-1935
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Country | US
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Telephone | 610-504-6732
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGEMENT
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Name | DR. RENEE CANTWELL
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Credential | ED.D.
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Telephone | 610-504-6732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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