Organization Name: | INTEGRATIVE THERAPY INSTITUTE |
NPI Number: | 1033509401 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS B HOLLENBACH (DIRECTOR) |
Mailing Address: | 340 Amboy Ave 2nd Floor Metuchen |
State: | NJ US |
Postal Code: | 088402438 |
Phone Number: | 7326904149 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2015 |
NPI Last Update Date: | 09/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 35SI00528000 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |