Healthcare Provider Details

I. General information

NPI: 1134554959
Provider Name (Legal Business Name): REBECCA HUTNER ZUSPAN M.S.W., L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 08/12/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 KINGS HWY E STE 103
HADDONFIELD NJ
08033-2009
US

IV. Provider business mailing address

29 W BEECHWOOD AVE
OAKLYN NJ
08107-1419
US

V. Phone/Fax

Practice location:
  • Phone: 856-312-3672
  • Fax:
Mailing address:
  • Phone: 215-919-5172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW018510
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05935500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: