Individual provider · NPI-1
Dr. Gerald D Mingin Jr., Ph.D. & Psy.D.
Social Worker, School · Southampton, NJ
NPI number1508348863
StatusActive
Last updated in NPPESSep 4, 2018
Details
- NPI
- 1508348863
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gerald D Mingin Jr.
- Credential
- Ph.D. & Psy.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 4, 2018
- Last updated
- Sep 4, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041S0200X | Social Worker, School | TR18313700243054 | NJ | Yes |
| 103TB0200X | Psychologist, Cognitive & Behavioral | – | NJ | |
| 103TE1100X | Psychologist, Exercise & Sports | – | NJ |
Practice location
135 Eayrestown Rd. Suite ASouthampton, NJ 08055
Phone 609-261-1022
Mailing address
135 Eayrestown Rd. Suite ASouthampton, NJ 08055
Phone 609-261-1022
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