Doctor Name: | KATHLEEN A VILARDI |
NPI Number: | 1679757447 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 35SI00319600 |
Business Practice Address: | 68 Forman St Fair Haven, NJ - 07704 |
Business Phone Number: | 7328040893 |
Business Fax Number: | |
Mailing Address: | 31 De Normandie Ave, FAIR HAVEN |
State: | NJ |
Postal Code: | 07704 |
Phone Number: | 7328040893 |
Fax Number: | |
NPI Enumeration Date: | 12/28/2007 |
NPI Last Update Date: | 12/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 35SI00319600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |