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Individual

MRS. MARY BETH HOUSEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., A.T.C., CSCS

Contact information

Practice address
354 SOUTH ST, NEW PROVIDENCE, NJ 07974-2129
(908) 577-2262
(908) 464-2682
Mailing address
354 SOUTH ST, NEW PROVIDENCE, NJ 07974-2129
(908) 577-2262
(908) 464-2682

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00118700
NJ
2255A2300X
Athletic Trainer
RT003369
PA

Other

Enumeration date
04/10/2006
Last updated
04/30/2010
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