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General NPI Number Information
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NPI Number | 1093396996
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Entity Type | Individual
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Provider Name | KATIE-ANN L MAGNUSON LPC
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Gender | Female
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 1124 US HIGHWAY 202 STE B10
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City | RARITAN
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State | NJ
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Zip | 08869-1463
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Country | US
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Telephone | 908-977-1650
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Fax |
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Provider Business Mailing Address
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Address Line | 1124 US HIGHWAY 202 STE B10
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City | RARITAN
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State | NJ
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Zip | 08869-1463
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Country | US
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Telephone | 908-977-1650
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00762200
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License Number State | NJ
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