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Individual

MARK EDWARD HERSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
220 FERNHEAD AVE, MONROE, NJ 08831-8736
(732) 995-9784
Mailing address
220 FERNHEAD AVE, MONROE, NJ 08831-8736

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
102X00000X
Poetry Therapist
103TC2200X
Clinical Child & Adolescent Psychologist
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001
DDD
Enumeration date
09/03/2019
Last updated
09/03/2019
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