| Maple Therapy Center LLC | |
|
65 N Maple Ave # 209 Ridgewood NJ 07450-3233 | |
| (201) 566-1535 | |
| Not Available |
| Full Name | Maple Therapy Center LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 65 N Maple Ave # 209, Ridgewood, New Jersey |
| Authorized Official Name and Position | Susan O Peterson (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2015661535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Therapy Center LLC 65 N Maple Ave # 209 Ridgewood NJ 07450-3233 Ph: (201) 566-1535 | Maple Therapy Center LLC 65 N Maple Ave # 209 Ridgewood NJ 07450-3233 Ph: (201) 566-1535 |
| NPI Number | 1225365372 |
|---|---|
| Provider Enumeration Date | 11/11/2009 |
| Last Update Date | 11/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225365372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC04898500 (New Jersey) | Primary |
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