| Inner Light Therapeutics, Llc | |
|
637 Wyckoff Ave Ste 172 Wyckoff NJ 07481-1438 | |
| (201) 298-1402 | |
| Not Available |
| Full Name | Inner Light Therapeutics, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 637 Wyckoff Ave Ste 172, Wyckoff, New Jersey |
| Authorized Official Name and Position | Bonnie Lyn Freirich (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2012981402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Light Therapeutics, Llc 637 Wyckoff Ave Ste 172 Wyckoff NJ 07481-1438 Ph: (201) 298-1402 | Inner Light Therapeutics, Llc 637 Wyckoff Ave Ste 172 Wyckoff NJ 07481-1438 Ph: (201) 298-1402 |
| NPI Number | 1174132492 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 07/23/2020 |
| Certification Date | 07/23/2020 |
| Medicare PECOS PAC ID | 8820404080 |
|---|---|
| Medicare Enrollment ID | O20210312001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174132492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bonnie L Freirich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447659354 PECOS PAC ID: 2264653484 Enrollment ID: I20141031000308 |
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