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General NPI Number Information
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NPI Number | 1447515010
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Entity Type | Organization
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Legal Business Name | SHANNON SANTORO
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 65 N MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3233
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Country | US
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Telephone | 973-271-8940
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Fax |
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Provider Business Mailing Address
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Address Line | 101 SILVER FOX TRL
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City | STOCKHOLM
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State | NJ
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Zip | 07460-1233
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Country | US
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Telephone | 973-271-8940
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | SHANNON SANTORO
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Credential |
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Telephone | 973-271-8940
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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 |
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License Number State |
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