Provider Demographics
NPI:1235514332
Name:GOLEMBIEWSKI, KATHERINE A (BC,B,A)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:A
Last Name:GOLEMBIEWSKI
Suffix:
Gender:F
Credentials:BC,B,A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2531
Mailing Address - Country:US
Mailing Address - Phone:609-970-8112
Mailing Address - Fax:
Practice Address - Street 1:825 GEORGES ROAD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-227-4050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-15-19145103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst