Individual
MONA C TALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
619 FERNWOOD AVE, PLEASANTVILLE, NJ 08232-4319
(609) 816-5199
Mailing address
619 FERNWOOD AVE, PLEASANTVILLE, NJ 08232-4319
(609) 816-5199
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05947600
NJ
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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