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Provider Information for 1063043305


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MIDELINE BELCHER LAC


Sex: Female

NPI: 1063043305
Last Updated: 2020-01-27
Certification Date: 2020-01-27

Details

NameValue
NPI1063043305
Enumeration Date2020-01-27
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 610 VALLEY HEALTH PLZ
PARAMUS, NJ 07652-3607
United States

Phone: 201-265-8200 | Fax:
 
Primary Practice Address 610 VALLEY HEALTH PLZ
PARAMUS, NJ 07652-3607
United States

Phone: 201-265-8200 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthNJ37AC00442500