Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 5658 | NJ |
N | 103T00000X | Psychologist | 5658 | NJ |
N | 103TA0700X | Adult Development & Aging Psychologist | 5658 | NJ |
Y | 103G00000X | Clinical Psychologist | 5658 | NJ |
Y | 103TC0700X | Clinical Psychologist | 5658 | NJ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 5658 | NJ |
N | 103TF0000X | Family Psychologist | 5658 | NJ |
N | 103TP2701X | Group Psychotherapist | 5658 | NJ |
NPI | 1992250153 |
---|---|
Provider Name | Dr. Faith Dunkel |
First Address | Montclair, NJ 07042-2129 |
Second Address | Montclair, NJ 07042-2129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2016 |
Last Update Date | 01/05/2018 |