Provider Demographics
NPI:1447671102
Name:IRWIN, PATRICIA LOUISE
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LOUISE
Last Name:IRWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:LOUISE
Other - Last Name:IRWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-0005
Mailing Address - Country:US
Mailing Address - Phone:856-935-3600
Mailing Address - Fax:856-935-9612
Practice Address - Street 1:150 SALEM WOODSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-0005
Practice Address - Country:US
Practice Address - Phone:856-935-3600
Practice Address - Fax:856-935-9612
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities