Individual
KIA MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
39 N CLINTON AVE BLDG 1, TRENTON, NJ 08609-1011
(609) 394-9398
Mailing address
39 N CLINTON AVE BLDG 1, TRENTON, NJ 08609-1011
(609) 394-9398
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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