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General NPI Number Information
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NPI Number | 1104512995
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Entity Type | Individual
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Provider Name | LYNDA M CORALUZZI LCADC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2023
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Last Update Date | 04/23/2023
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Provider Practice Location Address
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Address Line | 1302 WOODMONT CIR # 08080
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City | SEWELL
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State | NJ
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Zip | 08080-2275
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Country | US
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Telephone | 856-535-6593
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 WOODMONT CIR # 08080
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City | SEWELL
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State | NJ
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Zip | 08080-2275
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Country | US
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Telephone | 856-535-6593
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37LC00361700
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License Number State | OH
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