Provider Demographics
NPI:1932456647
Name:CRESANTI-DAKNIS, THERESE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:THERESE
Middle Name:MARIE
Last Name:CRESANTI-DAKNIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:THERESE
Other - Middle Name:MARIE
Other - Last Name:CRESANTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:105 HORSENECK POINT RD
Mailing Address - Street 2:
Mailing Address - City:OCEANPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07757-1121
Mailing Address - Country:US
Mailing Address - Phone:732-673-7108
Mailing Address - Fax:
Practice Address - Street 1:105 HORSENECK POINT RD
Practice Address - Street 2:
Practice Address - City:OCEANPORT
Practice Address - State:NJ
Practice Address - Zip Code:07757-1121
Practice Address - Country:US
Practice Address - Phone:732-673-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist