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NPI Profile for SURAIJA AGOSTO in NEW PROVIDENCE, NJ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Dance Therapist |
225600000X |
| NPI Number | 1326895251 |
|
| Status | Active | |
| Credentials | LAC | |
| Entity | Individual | |
| Enumeration date | 04/30/2024 | |
| Last updated | 04/30/2024 - About 2 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SURAIJA AGOSTO
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SURAIJA AGOSTO, LAC