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Individual

MELISSA MARIE RULLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCADC, LCSW

Contact information

Practice address
600 ROUTE 35, RED BANK, NJ 07701-5018
(732) 706-1300
Mailing address
22 LONDON DR, JACKSON, NJ 08527-2616
(732) 575-2975

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00255500
NJ
1041C0700X
Clinical Social Worker
44SC05710800
NJ

Other

Enumeration date
05/30/2018
Last updated
05/30/2018
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