Doctor Name: | MR. CAMILO E. MARMOLEJO |
NPI Number: | 1023387065 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, LPC, CSC |
License Number: | 809351 |
Business Practice Address: | 301 60th St West New York, NJ - 070935422 |
Business Phone Number: | 2012953033 |
Business Fax Number: | |
Mailing Address: | 301 60th St, WEST NEW YORK |
State: | NJ |
Postal Code: | 070935422 |
Phone Number: | 2012953033 |
Fax Number: | |
NPI Enumeration Date: | 12/20/2011 |
NPI Last Update Date: | 07/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | 809351 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |