Doctor Name: | DR. COLLEEN MARY GUNTESKI |
NPI Number: | 1649469404 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | TP # 073-837 |
Business Practice Address: | 617 Union Ave Building 3, Suite 20 Brielle, NJ - 087301838 |
Business Phone Number: | 7322233541 |
Business Fax Number: | 7322232731 |
Mailing Address: | 617 Union Ave, Building 3, Suite 20 BRIELLE |
State: | NJ |
Postal Code: | 087301838 |
Phone Number: | 7322233541 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2007 |
NPI Last Update Date: | 10/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | TP # 073-837 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |