Individual
MICHAEL FENIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9 VILLAGE CT, HAZLET, NJ 07730-1531
(732) 737-7105
Mailing address
9 VILLAGE CT, HAZLET, NJ 07730-1531
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00666000
NJ
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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