Doctor Name: | JANE ELIZABETH WILLENBORG |
NPI Number: | 1497803415 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 37PC00121000 |
Business Practice Address: | 73 Oak Ridge Road Newfoundland, NJ - 07435 |
Business Phone Number: | 9736978907 |
Business Fax Number: | |
Mailing Address: | 23 N Shore Rd, DENVILLE |
State: | NJ |
Postal Code: | 078341531 |
Phone Number: | 9735864554 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 37PC00121000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |