Individual
MELISSA GULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
166 MAIN ST, MATAWAN, NJ 07747
(732) 566-0433
Mailing address
166 MAIN ST, MATAWAN, NJ 07747-3104
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00378700
NJ
101YP2500X
Professional Counselor
Primary
37PC00743700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37AC00378700
—
NJ
Enumeration date
01/17/2019
Last updated
04/12/2026
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