Provider Demographics
NPI:1386454270
Name:TOTANJI, AYA
Entity type:Individual
Prefix:
First Name:AYA
Middle Name:
Last Name:TOTANJI
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 1:41 BLACK OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-7401
Mailing Address - Country:US
Mailing Address - Phone:201-315-2959
Mailing Address - Fax:
Practice Address - Street 1:1120 BLOOMFIELD AVE STE 200
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7131
Practice Address - Country:US
Practice Address - Phone:973-453-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor