Individual
MS. CARLY MARIE FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCADC
Contact information
Practice address
18 KINGS HWY STE 100, MIDDLETOWN, NJ 07748-2509
(732) 359-2212
Mailing address
18 KINGS HWY STE 100, MIDDLETOWN, NJ 07748-2509
(732) 359-2212
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06278200
NJ
Other
Enumeration date
09/15/2017
Last updated
01/09/2023
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