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General NPI Number Information
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NPI Number | 1871106328
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Entity Type | Organization
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Legal Business Name | KATHERINE DITMIRE THERAPY WORKS
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 450 TILTON RD STE 250
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1260
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Country | US
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Telephone | 609-271-7491
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Fax |
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Provider Business Mailing Address
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Address Line | 23 N DELSEA DR UNIT B
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City | CLAYTON
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State | NJ
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Zip | 08312-1637
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Country | US
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Telephone | 856-423-7700
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Fax | 856-423-0823
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHERINE E DITMIRE
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Credential | LCSW, LCADC
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Telephone | 609-271-7491
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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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