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General NPI Number Information
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NPI Number | 1831834951
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Entity Type | Individual
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Provider Name | TASH DUPLAIN LAC
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Gender | Male
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 271 ROUTE 46 W STE G201
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City | FAIRFIELD
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State | NJ
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Zip | 07004-2475
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Country | US
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Telephone | 973-934-0230
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Fax |
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Provider Business Mailing Address
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Address Line | 10B SHADY LN
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City | LITTLE FALLS
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State | NJ
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Zip | 07424-1407
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Country | US
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Telephone | 973-934-0230
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37AC00626000
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License Number State | NJ
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