Provider Demographics
NPI:1427203801
Name:ADORNETTO, ANN YELLAND (MED, LPC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:YELLAND
Last Name:ADORNETTO
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 STOKES RD. C-4
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3104
Mailing Address - Country:US
Mailing Address - Phone:609-714-0222
Mailing Address - Fax:
Practice Address - Street 1:520 STOKES RD STE C4
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2904
Practice Address - Country:US
Practice Address - Phone:609-714-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC0078600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health