Individual
ETHAN MOUTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 CRAIG RD STE 220, MANALAPAN, NJ 07726-8731
(732) 913-0033
Mailing address
22 HEMLOCK DR, JAMESBURG, NJ 08831-2529
(732) 580-6578
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06389000
NJ
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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