Individual
DAILA CARBONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 MARKET PL STE 5, GLASSBORO, NJ 08028-1406
(856) 842-2943
Mailing address
105 MARKET PL STE 5, GLASSBORO, NJ 08028-1406
(856) 842-2943
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
453626582
NJ
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
12/13/2016
Last updated
12/14/2016
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