Provider Demographics
NPI:1851795678
Name:MOTIWALA, MONISHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONISHA
Middle Name:
Last Name:MOTIWALA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:STE C20A
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2758
Mailing Address - Country:US
Mailing Address - Phone:609-250-2567
Mailing Address - Fax:
Practice Address - Street 1:1000 HERRONTOWN RD
Practice Address - Street 2:1 STORY BUILDING
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7716
Practice Address - Country:US
Practice Address - Phone:609-613-4754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00531400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical