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General NPI Number Information
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NPI Number | 1922407816
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Entity Type | Organization
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Legal Business Name | PRINCETON PSYCHOLOGY ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 601 EWING ST SUITE C20-A
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City | PRINCETON
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State | NJ
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Zip | 08540-2757
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Country | US
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Telephone | 609-250-2567
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Fax |
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Provider Business Mailing Address
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Address Line | 601 EWING ST SUITE C20-A
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City | PRINCETON
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State | NJ
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Zip | 08540-2757
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Country | US
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Telephone | 609-250-2567
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. MONISHA MOTIWALA
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Credential | PSY.D.
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Telephone | 609-250-2567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 35SI00531400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 35SI00531400
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License Number State | NJ
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