Doctor Name: | DR. LUCIENE (LUCY) SANT'ANNA TAKAGI |
NPI Number: | 1346508264 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 19014-1 |
Business Practice Address: | 882 Pompton Ave Ste A1 Cedar Grove, NJ - 070091256 |
Business Phone Number: | 9732390852 |
Business Fax Number: | 9732392597 |
Mailing Address: | 882 Pompton Ave Ste A1, CEDAR GROVE |
State: | NJ |
Postal Code: | 070091256 |
Phone Number: | 9732390852 |
Fax Number: | 9732392597 |
NPI Enumeration Date: | 04/28/2012 |
NPI Last Update Date: | 04/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 19014-1 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |