Individual provider · Type 1 NPI

Ida Vernelius Davistyson

Mental Health Counselor · Matawan, NJ

NPI number 1669113361 Active

Practice location

166 Main St
Matawan, NJ 07747-3104

Call (732) 290-9040 Map

Mailing address

1 Kyle Way
Ewing, NJ 08628-2508

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1669113361

Ida Vernelius Davistyson's National Provider Identifier is 1669113361, issued on Apr 5, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Matawan, NJ. The record was last updated on Apr 5, 2022.