Healthcare Provider Details

I. General information

NPI: 1043397953
Provider Name (Legal Business Name): MARION PATRICIA HOUGHTON L.M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PROSPECT ST SUITE D
SOUTH ORANGE NJ
07079-2103
US

IV. Provider business mailing address

378 VALLEY ST APT. C-5
SOUTH ORANGE NJ
07079-2827
US

V. Phone/Fax

Practice location:
  • Phone: 973-762-9130
  • Fax:
Mailing address:
  • Phone: 973-762-9130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FI001522200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: