Healthcare Provider Details
I. General information
NPI: 1417180191
Provider Name (Legal Business Name): MEREDITH ANNE PUHER M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/28/2009
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
218A SUNSETROAD SCREENING, CRISIS, & INTERVENTION PROGRAM (SCIP)
WILLINGBORO NJ
08046-1110
US
IV. Provider business mailing address
1289 ROUTE 38 WEST
HAINESPORT NJ
08036-2730
US
V. Phone/Fax
- Phone: 609-835-6180
- Fax: 609-835-7962
- Phone: 609-267-5656
- Fax: 609-267-8892
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: