| By Stephanie A | |
|
77 Tailor Ln Sicklerville NJ 08081-5697 | |
| (856) 275-3061 | |
| Not Available |
| Full Name | By Stephanie A |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 77 Tailor Ln, Sicklerville, New Jersey |
| Authorized Official Name and Position | Stephanie Moore (CEO) |
| Authorized Official Contact | 8562753061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| By Stephanie A 77 Tailor Ln Sicklerville NJ 08081-5697 Ph: (856) 275-3061 | By Stephanie A 77 Tailor Ln Sicklerville NJ 08081-5697 Ph: (856) 275-3061 |
| NPI Number | 1083386411 |
|---|---|
| Provider Enumeration Date | 10/04/2021 |
| Last Update Date | 10/04/2021 |
| Certification Date | 10/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083386411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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