Provider Demographics
NPI:1083748586
Name:GERBER, MARLENE (PSYCO-THERAPIST)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:GERBER
Suffix:
Gender:F
Credentials:PSYCO-THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5612
Mailing Address - Country:US
Mailing Address - Phone:973-305-0869
Mailing Address - Fax:
Practice Address - Street 1:116 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5612
Practice Address - Country:US
Practice Address - Phone:973-305-0869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ235482OtherMANAGED HEALTH NETWORK
NJ7125452OtherAETNA