| Doctor Name: | ALEXTER MUTIA |
| NPI Number: | 1407108582 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PMHNP-BC |
| License Number: | 26NJ00384800 |
| Business Practice Address: | 130 Powerville Rd Boonton, NJ - 070058705 |
| Business Phone Number: | 2013713076 |
| Business Fax Number: | |
| Mailing Address: | 130 Powerville Rd, BOONTON |
| State: | NJ |
| Postal Code: | 070058705 |
| Phone Number: | 2013713076 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2012 |
| NPI Last Update Date: | 08/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 26NJ00384800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |