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General NPI Number Information
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NPI Number | 1831330653
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Entity Type | Organization
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Legal Business Name | CONTEXTUAL FAMILY THERAPY OF SOUTH JERSEY
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 29 S BROAD ST
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City | WOODBURY
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State | NJ
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Zip | 08096-4655
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Country | US
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Telephone | 856-853-9300
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Fax | 856-461-5513
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Provider Business Mailing Address
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Address Line | 49 SAINT MIHIEL DR
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City | DELRAN
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State | NJ
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Zip | 08075-1037
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Country | US
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Telephone | 609-781-0441
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MARIE A. HULSE COWAN
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Credential | LMFT
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Telephone | 609-781-0441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37FI00148600
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License Number State | NJ
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