Provider Demographics
NPI:1497805089
Name:ROWER, MARY B (RN LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:B
Last Name:ROWER
Suffix:
Gender:F
Credentials:RN LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 UNION AVE UNIT 3-15
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1841
Mailing Address - Country:US
Mailing Address - Phone:732-223-0303
Mailing Address - Fax:732-223-0388
Practice Address - Street 1:617 UNION AVE UNIT 3-15
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1841
Practice Address - Country:US
Practice Address - Phone:732-223-0303
Practice Address - Fax:732-223-0388
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC046272001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ018837Medicare ID - Type Unspecified