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NPI Code Detail

MEDICARE: LIA MARCELETTE HANNON

MEDICARE: LIA MARCELETTE HANNON
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
1101YM0800XMental Health Counselor37AC00503000NJ

General Provider Information

NPI Number : 1518612605
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIA MARCELETTE HANNON
Provider Business Mailing Address
First Line : 4182 HARBOUR DR
Second Line :
City : PALMYRA
State : NJ
Zip : 08065-2108
Country : US
Telephone Number : 609-634-8049
Fax Number :
Provider Business Practice Location Address
First Line : 60 CATHY LN STE 103
Second Line :
City : BURLINGTON
State : NJ
Zip : 08016-9727
Country : US
Telephone Number : 609-499-0165
Fax Number : 609-499-0685
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2022
Last Update Date : 02/16/2022

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Directions to “ LIA MARCELETTE HANNON ” Practice Location

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