Provider Demographics
NPI:1730494436
Name:PUNTOLILLO, ANITRA (LPC)
Entity Type:Individual
Prefix:
First Name:ANITRA
Middle Name:
Last Name:PUNTOLILLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 DUTCH LANE RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2211
Mailing Address - Country:US
Mailing Address - Phone:732-577-0297
Mailing Address - Fax:
Practice Address - Street 1:35 DUTCH LANE RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2211
Practice Address - Country:US
Practice Address - Phone:732-577-0297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00406800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional