Individual
MR. GARY A FAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LPC
Contact information
Practice address
832 BRUNSWICK AVENUE, BERMINGHAM CLINIC, TRENTON, NJ 08638-3829
(609) 396-8877
(609) 396-6024
Mailing address
1001 SPRUCE STREET SUITE 205, GREATER TRENTON BEHAVIORAL HEALTHCARE, TRENTON, NJ 08638-3957
(609) 396-6788
(609) 989-1245
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37PC00060900
NJ
101YM0800X
Mental Health Counselor
37PC00060900
NJ
101YP2500X
Professional Counselor
37PC00060900
NJ
Other
Enumeration date
05/29/2008
Last updated
07/08/2008
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