Doctor Name: | DR. MYCHELLE MARIE TORRES |
NPI Number: | 1164584835 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 35S100524800 |
Business Practice Address: | 420 Boulevard Suite 101 Mountain Lakes, NJ - 070461742 |
Business Phone Number: | 9733214380 |
Business Fax Number: | 9737945350 |
Mailing Address: | 420 Boulevard, Suite 101 MOUNTAIN LAKES |
State: | NJ |
Postal Code: | 070461742 |
Phone Number: | 9733214380 |
Fax Number: | 9737945350 |
NPI Enumeration Date: | 12/15/2006 |
NPI Last Update Date: | 04/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 35S100524800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |