Individual
CORRYN DEFAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
258 NEWARK ST STE 205, HOBOKEN, NJ 07030-3418
(908) 975-1853
Mailing address
258 NEWARK ST STE 205, HOBOKEN, NJ 07030-3418
(908) 975-1853
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00755700
NJ
Other
Enumeration date
09/21/2024
Last updated
09/21/2024
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