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General NPI Number Information
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NPI Number | 1780965939
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Entity Type | Organization
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Legal Business Name | BRIE DONZELLA, LPC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 116 OCEANPORT AVE
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City | LITTLE SILVER
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State | NJ
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Zip | 07739-1211
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Country | US
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Telephone | 732-824-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 116 OCEANPORT AVE
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City | LITTLE SILVER
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State | NJ
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Zip | 07739-1211
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Country | US
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Telephone | 732-824-2345
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PROFFESSIONAL
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Name | BRIE DONZELLA
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Credential | LPC
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Telephone | 732-824-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 37PC00320900
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License Number State | NJ
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