Provider Demographics
NPI:1508047101
Name:CONTRERAS, LUISA AMARILIS (EDD)
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:AMARILIS
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 FORT LEE RD
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1952
Mailing Address - Country:US
Mailing Address - Phone:201-871-3737
Mailing Address - Fax:
Practice Address - Street 1:271 FORT LEE RD STE 3
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-1944
Practice Address - Country:US
Practice Address - Phone:201-871-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-25
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
NJ35SI00404700103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling