| Doctor Name: | MRS. VASHONNA ETIENNE |
| NPI Number: | 1053654806 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 44SC05537800 |
| Business Practice Address: | 297 Kinderkamack Rd Suite 214 Oradell, NJ - 076491538 |
| Business Phone Number: | 2014916060 |
| Business Fax Number: | 2014382984 |
| Mailing Address: | 2410 2nd St, FORT LEE |
| State: | NJ |
| Postal Code: | 070244004 |
| Phone Number: | 2014916060 |
| Fax Number: | 2013464365 |
| NPI Enumeration Date: | 03/30/2013 |
| NPI Last Update Date: | 10/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 44SC05537800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |