Individual
MS. DIANE M. RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATR, LPC
Contact information
Practice address
53 S MAIN ST, MEDFORD, NJ 08055-2442
(609) 923-7810
Mailing address
15 TAHTEEPAY TRL, MEDFORD LAKES, NJ 08055-2126
(609) 654-4643
(609) 953-1367
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC00299900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043524
—
NJ
01
—
3670176
AETNA
NJ
Enumeration date
02/14/2007
Last updated
07/08/2007
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