Provider Demographics
NPI:1932939378
Name:ROSKIN, DINA (MA, EDS, LAC)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:ROSKIN
Suffix:
Gender:F
Credentials:MA, EDS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 RUTGERS ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2803
Mailing Address - Country:US
Mailing Address - Phone:646-382-6163
Mailing Address - Fax:
Practice Address - Street 1:25B HANOVER RD
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1442
Practice Address - Country:US
Practice Address - Phone:973-295-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00796200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional