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General NPI Number Information
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NPI Number | 1710629258
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Entity Type | Individual
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Provider Name | LISA MARIE MUNN MS, LCADC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 923 HADDONFIELD RD STE 308
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2752
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Country | US
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Telephone | 856-324-8308
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Fax |
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Provider Business Mailing Address
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Address Line | 924 SOMERSET ST
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City | GLOUCESTER CITY
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State | NJ
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Zip | 08030-1857
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Country | US
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Telephone | 609-320-3336
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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 | 37LC00238000
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License Number State | NJ
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