Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1932456647 |
---|---|
Provider Name | Dr. Therese Marie Cresanti-Daknis |
First Address | Oceanport, NJ 07757-1121 |
Second Address | Oceanport, NJ 07757-1121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2012 |
Last Update Date | 13/08/2012 |