Mary Ellen Fassnacht | |
1250 Rte 23 Butler NJ 07405-2037 | |
(973) 722-9831 | |
Not Available |
Full Name | Mary Ellen Fassnacht |
---|---|
Speciality | Social Worker - Clinical |
Location | 1250 Rte 23, Butler, New Jersey |
Authorized Official Name and Position | Mary Ellen Fassnacht (OWNER/PROVIDER) |
Authorized Official Contact | 9737229831 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mary Ellen Fassnacht 317 Godwin Ave Midland Park NJ 07432-1519 Ph: () - | Mary Ellen Fassnacht 1250 Rte 23 Butler NJ 07405-2037 Ph: (973) 722-9831 |
NPI Number | 1013564079 |
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Provider Enumeration Date | 08/23/2019 |
Last Update Date | 08/23/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013564079 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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