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General NPI Number Information
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NPI Number | 1841925922
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Entity Type | Organization
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Legal Business Name | FIRST LIGHT THERAPY LLC
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 258 NEWARK ST STE 208
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City | HOBOKEN
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State | NJ
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Zip | 07030-3418
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Country | US
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Telephone | 908-758-4624
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6188
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City | HOBOKEN
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State | NJ
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Zip | 07030-7204
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Country | US
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Telephone | 978-852-4758
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ALLISON LOEB
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Credential |
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Telephone | 908-758-4624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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