Healthcare Provider Details

I. General information

NPI: 1609174135
Provider Name (Legal Business Name): M&M CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 MILLBURN AVE SUITE D1
MAPLEWOOD NJ
07040-3725
US

IV. Provider business mailing address

2130 MILLBURN AVE SUITE D1
MAPLEWOOD NJ
07040-3725
US

V. Phone/Fax

Practice location:
  • Phone: 973-839-1003
  • Fax: 973-839-3653
Mailing address:
  • Phone: 973-839-1003
  • Fax: 973-839-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: WANDA MYERS
Title or Position: LCSW
Credential:
Phone: 973-839-1003