Doctor Name: | RANDI LEE ESASKY |
NPI Number: | 1255739876 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 109 Tensaw Dr Browns Mills, NJ - 080156638 |
Business Phone Number: | 6098930378 |
Business Fax Number: | |
Mailing Address: | 109 Tensaw Dr, BROWNS MILLS |
State: | NJ |
Postal Code: | 080156638 |
Phone Number: | 6098930378 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2014 |
NPI Last Update Date: | 12/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |