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1548000581
NICOLE ELIZABETH DESHAN
MEDFORD, NJ
NPI
1548000581
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NJ 37AC00793700)
Enumeration Date
2024-05-28
Last Update Date
2024-05-28
Business Address
NICOLE ELIZABETH DESHAN
32 S MAIN ST
MEDFORD, NJ 08055-2455
Phone number: 856-617-4544
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Mailing Address
NICOLE ELIZABETH DESHAN
2 WISINA CT
MEDFORD, NJ 08055-9349
Phone number: 609-556-3215
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