Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC00538500 | NJ |
NPI | 1003159724 |
---|---|
Provider Name | Christine Mcgowan |
First Address | Bayville, NJ 08721-1229 |
Second Address | Bayville, NJ 08721-1229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 10/12/2015 |