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General NPI Number Information
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NPI Number | 1003405440
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Entity Type | Individual
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Provider Name | JASON R FRIEL MS, LAC
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Gender | Male
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Dates
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Enumeration Date | 01/11/2021
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 630 CLEMENTS BRIDGE RD
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City | BARRINGTON
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State | NJ
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Zip | 08007-1814
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Country | US
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Telephone | 856-547-1107
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Fax |
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Provider Business Mailing Address
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Address Line | 268 MEYNER DR
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City | BELLMAWR
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State | NJ
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Zip | 08031-2058
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Country | US
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Telephone | 856-332-0592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00432200
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License Number State | NJ
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