| Self Employed | |
|
349 Franklin Ave Ste 205 Nutley NJ 07110-1645 | |
| (862) 452-4883 | |
| Not Available |
| Full Name | Self Employed |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 349 Franklin Ave Ste 205, Nutley, New Jersey |
| Authorized Official Name and Position | Melissa J Middleman (MELISSA MIDDLEMAN, LCSW) |
| Authorized Official Contact | 8624524883 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Employed 349 Franklin Ave Ste 205 Nutley NJ 07110-1645 Ph: (862) 452-4883 | Self Employed 349 Franklin Ave Ste 205 Nutley NJ 07110-1645 Ph: (862) 452-4883 |
| NPI Number | 1437855152 |
|---|---|
| Provider Enumeration Date | 02/03/2023 |
| Last Update Date | 02/03/2023 |
| Certification Date | 02/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437855152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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