Provider Demographics
NPI:1700900453
Name:FLINT, ANTONIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANTONIA
Middle Name:
Last Name:FLINT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SALEM CT APT 8
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-7041
Mailing Address - Country:US
Mailing Address - Phone:609-356-0029
Mailing Address - Fax:609-356-0031
Practice Address - Street 1:22 STOCKTON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6813
Practice Address - Country:US
Practice Address - Phone:609-924-0060
Practice Address - Fax:609-924-7436
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005944001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical