Provider Demographics
NPI:1447547534
Name:LOEWRIGKEIT, NICOLE ENJOLI
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ENJOLI
Last Name:LOEWRIGKEIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 GARVEY RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3628
Mailing Address - Country:US
Mailing Address - Phone:973-865-9078
Mailing Address - Fax:
Practice Address - Street 1:19 GARVEY RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3628
Practice Address - Country:US
Practice Address - Phone:973-865-9078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst