Most Relevant Information
Provider Data
| NPI Number: | 1003326273 |
| Provider Name: | STEPHANIE DOMNITZ |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/02/2017 |
| Last Updated: | 10/02/2017 |
Provider Practice Location
17-07 ROMAINE ST
FAIR LAWN
NJ
074102150
Practice Location Phone/Fax
| Phone: | 2017972660 |
| Fax: |
Provider Mailing Location
12 JAROMBEK DR
TOWACO
NJ
070821442
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |