Doctor Name: | JENNIFER J VICTORIA-PROANO |
NPI Number: | 1215293576 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LAC, CBIS |
License Number: | 37AC00060900 |
Business Practice Address: | 18-01 Pollitt Drive Suite 1a Fair Lawn, NJ - 07410 |
Business Phone Number: | 2014784200 |
Business Fax Number: | 2014784202 |
Mailing Address: | 18-01 Pollitt Dr Ste 1a, FAIR LAWN |
State: | NJ |
Postal Code: | 074102815 |
Phone Number: | 2014784200 |
Fax Number: | 2014784202 |
NPI Enumeration Date: | 04/11/2012 |
NPI Last Update Date: | 04/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 37AC00060900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |