Davis, Marlene Phyllis

Davis, Marlene Phyllis is an individual health care provider with primary practice located at 659 Eagle Rock Ave , West Orange NJ 07052. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Davis, Marlene Phyllis can be contacted via phone (973) 736-3002.

Contact Information

Primary practice address
659 Eagle Rock Ave West Orange NJ 07052
Phone: (973) 736-3002
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SC00886 New Jersey
Behavioral Health & Social Service Providers / Clinical 1041C0700X R0315731 New York

Profile Details

NPI number 1588733265
LBN Legal business name Davis, Marlene Phyllis
Credentials MSW MED MA
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588733265 NPPES
New Jersey Other E5292 OXFORD
New Jersey Other 121V34000 OXFORD

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