Individual
MISS REGINA MARIE FACCHINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
3349 HIGHWAY 138, WALL TOWNSHIP, NJ 07719-9671
(732) 280-6050
Mailing address
31 VIRGINIA AVE, HAZLET, NJ 07730-2249
(732) 598-9792
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TL-2617
NJ
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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