Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 37LC00243600 | NJ |
NPI | 1003440173 |
---|---|
Provider Name | Ms. Carolanne Brennan |
First Address | Turnersville, NJ 08012-1441 |
Second Address | Haddon Township, NJ 08108-2634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2020 |
Last Update Date | 27/02/2020 |