Amyrath-Laye A Souradjou
Individual provider Active NPI Counselor · Voorhees, NJ
NPI 1457742256 · NPPES record last updated Feb 16, 2015
Key facts
- NPI
- 1457742256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 108 Lucas LN
Voorhees, NJ 08043-2549 - Phone
- (856) 772-0060
- NPI assigned
- Feb 16, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
108 Lucas LN
Voorhees, NJ 08043-2549
Mailing address
770 Woodlane Rd
Westampton, NJ 08060-3804
Phone (609) 267-5928
Other providers in Voorhees, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.