Provider Demographics
NPI:1639408867
Name:PANARELLO, ANNMARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNMARIE
Middle Name:
Last Name:PANARELLO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 RICHEY AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-2328
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:326 PENN ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08102
Practice Address - Country:US
Practice Address - Phone:856-225-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2018-12-04
Deactivation Date:2016-12-28
Deactivation Code:
Reactivation Date:2018-10-05
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NJ35S100536900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health