Individual provider · Type 1 NPI
Anthony Defazio, MA
Addiction (Substance Use Disorder) Counselor · Wall, NJ
NPI number
1962850198
Active
Practice location
1540 Rte 138 Ste 202
Wall, NJ 07719-3765
Fax (732) 515-9159
Mailing address
1540 Rt 138 Suite 202
Wall, NJ 07719
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Other addiction (substance use disorder) counselor providers in Wall
About NPI 1962850198
Anthony Defazio, MA's National Provider Identifier is 1962850198, issued on May 27, 2016. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Wall, NJ. The record was last updated on Mar 7, 2017.