Provider Demographics
NPI:1427106004
Name:BRESLOW, AMY A (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:A
Last Name:BRESLOW
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 E. MARLTON PIKE
Mailing Address - Street 2:STE N-70
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2150
Mailing Address - Country:US
Mailing Address - Phone:856-985-6300
Mailing Address - Fax:856-985-6424
Practice Address - Street 1:1930 E. MARLTON PIKE
Practice Address - Street 2:STE N-70
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-985-6300
Practice Address - Fax:856-985-6424
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC044075001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical