Healthcare Provider Details

I. General information

NPI: 1669697272
Provider Name (Legal Business Name): MRS. MARLA M TALARICO SCHECHTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 TATUM ST
WOODBURY NJ
08096-3499
US

IV. Provider business mailing address

138 HEIDI LN
SWEDESBORO NJ
08085-1527
US

V. Phone/Fax

Practice location:
  • Phone: 856-845-8050
  • Fax:
Mailing address:
  • Phone: 856-371-3591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: