Individual
MRS. KETTY MARY MUSHARBASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
80 AVENUE C, BAYONNE, NJ 07002-2439
(201) 243-6109
Mailing address
80 AVENUE C, BAYONNE, NJ 07002-2439
(201) 243-6109
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06235400
NJ
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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