Provider Demographics
NPI:1538281431
Name:VROOM, PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:VROOM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 SHREWSBURY CT
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5258
Mailing Address - Country:US
Mailing Address - Phone:609-818-1226
Mailing Address - Fax:
Practice Address - Street 1:137 SHREWSBURY CT
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-5258
Practice Address - Country:US
Practice Address - Phone:609-818-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015611-1103TC0700X
NJ061-A276103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical