Individual
CONSTANCE DE MARTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39 N FULLERTON AVE APT E9, MONTCLAIR, NJ 07042-3479
(973) 868-1157
Mailing address
39 N FULLERTON AVE APT E9, MONTCLAIR, NJ 07042-3479
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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