| Holistic Therapy By Design | |
|
30 Moran St Newton NJ 07860-1832 | |
| (973) 963-1038 | |
| Not Available |
| Full Name | Holistic Therapy By Design |
|---|---|
| Speciality | Social Worker |
| Location | 30 Moran St, Newton, New Jersey |
| Authorized Official Name and Position | Lori S Petry (OWNER) |
| Authorized Official Contact | 9739631038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holistic Therapy By Design Po Box 345 Newton NJ 07860-0345 Ph: (973) 963-1038 | Holistic Therapy By Design 30 Moran St Newton NJ 07860-1832 Ph: (973) 963-1038 |
| NPI Number | 1154789303 |
|---|---|
| Provider Enumeration Date | 02/03/2016 |
| Last Update Date | 02/03/2016 |
| Medicare PECOS PAC ID | 4981908001 |
|---|---|
| Medicare Enrollment ID | O20160210002481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154789303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC00031600 (New Jersey) | Primary |
| Provider Name | Lori S Petry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073663803 PECOS PAC ID: 0840594966 Enrollment ID: I20160210002659 |
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