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Individual

MARIA ANNUNZIATA FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED, LAC, NCC

Contact information

Practice address
666 GODWIN AVE STE AND330, MIDLAND PARK, NJ 07432-1449
(551) 319-2029
Mailing address
860 WYCKOFF AVE STE AND303, MAHWAH, NJ 07430-3186
(551) 319-2029

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37AC00710200
NJ

Other

Enumeration date
03/13/2023
Last updated
03/13/2023
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