Individual
MELANIE DEFAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
103 MOUNTAINSIDE DR, POMPTON LAKES, NJ 07442-1760
(973) 598-5317
Mailing address
103 MOUNTAINSIDE DR, POMPTON LAKES, NJ 07442-1760
(973) 598-5317
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37PC00381500
NJ
Other
Enumeration date
08/16/2012
Last updated
08/16/2012
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