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6102 Hamilton Way Eastampton Township NJ 08060-1673 | |
(484) 515-6125 | |
(609) 400-4888 |
Full Name | |
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Speciality | Counselor - Professional |
Location | 6102 Hamilton Way, Eastampton Township, New Jersey |
Authorized Official Name and Position | Shannon Shadman (PROFESSIONAL COUNSELOR) |
Authorized Official Contact | 4845156125 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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30 Brandywine Rd Pemberton NJ 08068-1307 Ph: (484) 515-6125 | 6102 Hamilton Way Eastampton Township NJ 08060-1673 Ph: (484) 515-6125 |
NPI Number | 1386100808 |
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Provider Enumeration Date | 02/20/2019 |
Last Update Date | 12/08/2022 |
Certification Date | 12/08/2022 |
Identifier | Type | State | Issuer |
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1386100808 | NPI | - | NPPES |
37PC00591200 | Other | NJ | LICENSE NUMBER |