| Doctor Name: | MRS. MARYELLEN GUADAGNO |
| NPI Number: | 1336254895 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 072487 |
| Business Practice Address: | 1289 Route 38 West Suite 101 Hainesport, NJ - 08036 |
| Business Phone Number: | 6092671377 |
| Business Fax Number: | |
| Mailing Address: | 1289 Route 38 West, Suite 101 HAINESPORT |
| State: | NJ |
| Postal Code: | 08036 |
| Phone Number: | 6092613330 |
| Fax Number: | 6092651064 |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 10/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 072487 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |