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General NPI Number Information
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NPI Number | 1861829806
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Entity Type | Organization
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Legal Business Name | THE ATTACHMENT ALLIANCE
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Dates
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Enumeration Date | 10/05/2013
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Last Update Date | 10/05/2013
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Provider Practice Location Address
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Address Line | 605 BLOOMFIELD AVE SUITE 3
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2859
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Country | US
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Telephone | 973-534-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 605 BLOOMFIELD AVE SUITE 3
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City | MONTCLAIR
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State | NJ
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Zip | 07042
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Country | US
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Telephone | 973-534-6680
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | BRIDGET M DEVINE
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Credential | MSW
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Telephone | 973-534-6680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL05249800
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License Number State | NJ
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