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General NPI Number Information
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NPI Number | 1891912341
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Entity Type | Individual
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Provider Name | JEAN M. CHRISTIE LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1460 LIVINGSTON AVE
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1832
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Country | US
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Telephone | 732-729-3600
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Fax | 732-435-0222
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Provider Business Mailing Address
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Address Line | 1 DOBSON RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816
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Country | US
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Telephone | 732-257-6565
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC01450500
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License Number State | NJ
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