Individual
PATRICIA FONSECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
700 AIRPORT ROAD, PREFERRED BEHAVIORAL HEALTH, LAKEWOOD, NJ 08701
(732) 367-4700
(732) 364-2253
Mailing address
1430 TOWERS ST, LAKEWOOD, NJ 08701-5447
(732) 905-9404
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37CA00045200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
02/08/2007
Last updated
07/09/2007
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