Doctor Name: | MS. JANINE M MARIS |
NPI Number: | 1063680205 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 44SC05214800 |
Business Practice Address: | 200 Woodport Rd Unit B Sparta, NJ - 078712628 |
Business Phone Number: | 9737263772 |
Business Fax Number: | 9737263775 |
Mailing Address: | 200 Woodport Rd, Unit B SPARTA |
State: | NJ |
Postal Code: | 078712628 |
Phone Number: | 9737263772 |
Fax Number: | 9737263775 |
NPI Enumeration Date: | 02/11/2008 |
NPI Last Update Date: | 04/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 44SC05214800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |