Individual
SUMMER B BRANCOCCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, LCADC
Contact information
Practice address
120 CHESTNUT STREET, RIDGEWOOD, NJ 07450
(201) 444-3550
Mailing address
797 EDGEWOOD LANE, FORT LEE, NJ 07024
(201) 917-5493
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00183400
NJ
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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