Organization
BEHAVIORAL MEDICINE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R MCGOWAN PH. D (PSYCHOLOGIST)
(856) 222-0783
Entity
Organization
Contact information
Practice address
3829 CHURCH RD, MOUNT LAUREL, NJ 08054-1105
(856) 222-0783
Mailing address
3829 CHURCH RD, MOUNT LAUREL, NJ 08054-1105
(856) 222-0783
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
35S100302200
NJ
103TC0700X
Clinical Psychologist
35S100302200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7791402
—
NJ
Enumeration date
11/08/2006
Last updated
04/22/2009
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