Provider Demographics
NPI:1073735841
Name:MCLEAN, ANITA (PHD, PSYD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COUNSELING AND PSYCHOLOGICAL SERVICES
Mailing Address - Street 2:PRINCETON UNIVERSITY
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08544-0001
Mailing Address - Country:US
Mailing Address - Phone:609-258-3285
Mailing Address - Fax:
Practice Address - Street 1:COUNSELING AND PSYCHOLOGICAL SERVICES
Practice Address - Street 2:PRINCETON UNIVERSITY
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08544-0001
Practice Address - Country:US
Practice Address - Phone:609-258-3285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4101103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical