Provider Demographics
NPI:1013373182
Name:HOWARD, TIERRAH SULTANA (LSW)
Entity Type:Individual
Prefix:MISS
First Name:TIERRAH
Middle Name:SULTANA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 EAGLE ROCK AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2954
Mailing Address - Country:US
Mailing Address - Phone:862-704-6391
Mailing Address - Fax:
Practice Address - Street 1:642 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2954
Practice Address - Country:US
Practice Address - Phone:862-704-6391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06064200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker