Most Relevant Information
Provider Data
| NPI Number: | 1003599937 |
| Provider Name: | ALEXIS TARANTOLA |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 44SL06998200 |
Most Important Dates
| Enumeration Date: | 08/08/2023 |
| Last Updated: | 08/08/2023 |
Provider Practice Location
166 MAIN ST
MATAWAN
NJ
077473104
Practice Location Phone/Fax
| Phone: | 7322909040 |
| Fax: |
Provider Mailing Location
166 MAIN ST
MATAWAN
NJ
077473104
Provider Mailing Phone/Fax
| Phone: | 7322909040 |
| Fax: |