Basic Information
| Provider Information | |||||||||
| NPI: | 1881077899 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMEED | ||||||||
| FirstName: | ASHANTI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 770 WOODLANE RD | ||||||||
| Address2: | |||||||||
| City: | MT. HOLLY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092675928 | ||||||||
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| Practice Location | |||||||||
| Address1: | 85 UNION ST | ||||||||
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| City: | MEDFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080552432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096549860 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2015 | ||||||||
| LastUpdateDate: | 07/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.