Individual
DONNA MARIE CICCONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11 S FULLERTON AVE, MONTCLAIR, NJ 07042-6304
(973) 744-8400
(973) 284-1195
Mailing address
11 S FULLERTON AVE, MONTCLAIR, NJ 07042-6304
(973) 744-8400
(973) 284-1195
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04532400
NJ
Other
Enumeration date
03/10/2007
Last updated
07/08/2007
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