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General NPI Number Information
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NPI Number | 1104942937
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Entity Type | Individual
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Provider Name | CAMILLE ROSE PALOMBO M.ED, LPC
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 901 OLD MARLTON PIKE W EXECUTIVE BLD
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City | MARLTON
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State | NJ
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Zip | 08053-2080
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Country | US
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Telephone | 609-953-4769
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Fax | 609-654-6218
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Provider Business Mailing Address
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Address Line | 704 GRAVELLY HOLLOW RD
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City | MEDFORD
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State | NJ
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Zip | 08055-8465
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Country | US
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Telephone | 609-654-4825
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Fax | 609-654-6218
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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 | PC01133
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License Number State | NJ
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