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General NPI Number Information
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NPI Number | 1366111320
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Entity Type | Individual
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Provider Name | OLIVIA S. MCCLENTON MA
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Gender | Female
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Dates
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Enumeration Date | 09/12/2021
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Last Update Date | 09/12/2021
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Provider Practice Location Address
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Address Line | 121 JOHNSON ROAD STE. 5
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City | TURNERSVILLE
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State | NJ
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Zip | 08012
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Country | US
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Telephone | 856-373-5370
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Fax |
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Provider Business Mailing Address
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Address Line | 18 N SMITH ST
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City | AVENEL
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State | NJ
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Zip | 07001-1707
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Country | US
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Telephone | 732-910-1868
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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 |
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License Number State |
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