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General NPI Number Information
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NPI Number | 1174054332
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Entity Type | Individual
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Provider Name | GRACE MARIE NUZZI-CHABOT LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 230 N MAPLE AVE
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City | MARLTON
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State | NJ
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Zip | 08053-9400
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Country | US
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Telephone | 856-226-7053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 744
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City | VOORHEES
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State | NJ
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Zip | 08043-0744
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Country | US
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Telephone | 856-226-7053
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SL06236500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05893800
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License Number State | NJ
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