MEDICARE: DR. RENEE R MAUCHER PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	35SI005754	NJ
2	103TC0700X	Clinical Psychologist	35SI005754	NJ

General Provider Information

NPI Number	:	1306101621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENEE R MAUCHER PSY.D.

Provider Business Mailing Address
First Line	:	3625 QUAKERBRIDGE RD
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1268
Country	:	US
Telephone Number	:	609-890-8844
Fax Number	:	609-890-8817

Provider Business Practice Location Address
First Line	:	3625 QUAKERBRIDGE RD
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1268
Country	:	US
Telephone Number	:	609-890-8844
Fax Number	:	609-890-8817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2012
Last Update Date	:	04/25/2017

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