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General NPI Number Information
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NPI Number | 1740337732
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Entity Type | Organization
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Legal Business Name | WALTER & MARY COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 09/30/2007
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Provider Practice Location Address
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Address Line | 405 BRIDGE PLAZA DR
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City | MANALAPAN
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State | NJ
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Zip | 07726-1735
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Country | US
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Telephone | 732-972-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 405 BRIDGE PLAZA DR
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City | MANALAPAN
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State | NJ
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Zip | 07726-1735
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Country | US
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Telephone | 732-972-7740
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JANINE FONFARA
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Credential | LCSW
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Telephone | 732-972-7740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | NJ 44SC05208400
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License Number State | NJ
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