Provider Demographics
NPI:1306393509
Name:BRUCE, MARGARET M (LAC, NBCC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:BRUCE
Suffix:
Gender:F
Credentials:LAC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3103 FALCON CT
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-5501
Mailing Address - Country:US
Mailing Address - Phone:856-575-4150
Mailing Address - Fax:
Practice Address - Street 1:333 IRVING AVE
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-2123
Practice Address - Country:US
Practice Address - Phone:856-575-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00209800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health