Individual
MICHELLE LYNN FUMOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC, ICADC, CCS
Contact information
Practice address
222 MEMORIAL PKWY, BLOOMFIELD, NJ 07003-4261
(973) 534-4923
Mailing address
222 MEMORIAL PKWY, BLOOMFIELD, NJ 07003-4261
(735) 344-9239
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00311700
NJ
Other
Enumeration date
03/25/2022
Last updated
07/19/2023
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