Individual
SHANIQUE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58 EUCLID ST, WOODBURY, NJ 08096-4626
(856) 628-4504
Mailing address
58 EUCLID ST, WOODBURY, NJ 08096-4626
(856) 628-4504
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06258700
NJ
Other
Enumeration date
02/28/2020
Last updated
02/28/2020
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