Provider Demographics
NPI:1588380380
Name:HADDONFIELD THERAPY ARTS, LLC
Entity type:Organization
Organization Name:HADDONFIELD THERAPY ARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPPALARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-304-2258
Mailing Address - Street 1:118 N HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2306
Mailing Address - Country:US
Mailing Address - Phone:609-304-2258
Mailing Address - Fax:
Practice Address - Street 1:118 N HADDON AVE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2306
Practice Address - Country:US
Practice Address - Phone:609-304-2258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty