Most Relevant Information
Provider Data
| NPI Number: | 1003515503 |
| Provider Name: | MARY T DERIENZO LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 37PC00071500 |
Most Important Dates
| Enumeration Date: | 02/23/2023 |
| Last Updated: | 02/23/2023 |
Provider Practice Location
818 CENTER ST
GARWOOD
NJ
070271416
Practice Location Phone/Fax
| Phone: | 9086707768 |
| Fax: |
Provider Mailing Location
818 CENTER ST
GARWOOD
NJ
070271416
Provider Mailing Phone/Fax
| Phone: | 9086707768 |
| Fax: |