Organization
EXPLORE THE CHALLENGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM R. FATUM (PRESIDENT)
(609) 893-5600
Entity
Organization
Contact information
Practice address
30 TECUMSEH TRL, BROWNS MILLS, NJ 08015-6108
(609) 893-5600
(609) 893-3082
Mailing address
PO BOX 207, NEW LISBON, NJ 08064-0207
(609) 893-5600
(609) 893-3082
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00088900
NJ
Other
Enumeration date
05/21/2007
Last updated
08/06/2008
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