Provider Demographics
NPI:1962774950
Name:NIEDZIELSKI, CHRISTINA (MA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:NIEDZIELSKI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-1846
Mailing Address - Country:US
Mailing Address - Phone:732-635-9797
Mailing Address - Fax:732-635-1711
Practice Address - Street 1:402 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-1846
Practice Address - Country:US
Practice Address - Phone:732-635-9797
Practice Address - Fax:732-635-1711
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00440700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional