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1194303073
EILEEN ANNE FASANELLA
MONTCLAIR, NJ
NPI
1194303073
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: NJ 41YS00206300)
Enumeration Date
2021-03-31
Last Update Date
2021-03-31
Business Address
EILEEN ANNE FASANELLA
2 WOODMONT RD
MONTCLAIR, NJ 07043-2500
Phone number: 973-818-2164
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Mailing Address
EILEEN ANNE FASANELLA
2 WOODMONT RD
MONTCLAIR, NJ 07043-2500
Phone number: 973-818-2164
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