Doctor Name: | MR. MATTHEW SAMUELS |
NPI Number: | 1487003232 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A, L.A.C |
License Number: | 37AC00310700 |
Business Practice Address: | 17 Harper Rd Monmouth Junction, NJ - 088522964 |
Business Phone Number: | 7324928898 |
Business Fax Number: | |
Mailing Address: | 17 Harper Rd, MONMOUTH JUNCTION |
State: | NJ |
Postal Code: | 088522964 |
Phone Number: | 7324928898 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2016 |
NPI Last Update Date: | 06/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 37AC00310700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |