Provider Demographics
NPI:1720318686
Name:PALMER, DORITHA B (LCSW)
Entity Type:Individual
Prefix:
First Name:DORITHA
Middle Name:B
Last Name:PALMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 PRINCETON AVE
Mailing Address - Street 2:C/O ERP&M
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2020
Mailing Address - Country:US
Mailing Address - Phone:609-466-3566
Mailing Address - Fax:609-466-7472
Practice Address - Street 1:83 PRINCETON AVE
Practice Address - Street 2:C/O ERP&M
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-2020
Practice Address - Country:US
Practice Address - Phone:609-466-3566
Practice Address - Fax:609-466-7472
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003627001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical