Provider Demographics
NPI:1942410154
Name:DEAN, MARY ELISABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELISABETH
Last Name:DEAN
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:54 BROAD ST
Mailing Address - Street 2:SUITE L-101
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1943
Mailing Address - Country:US
Mailing Address - Phone:732-747-6311
Mailing Address - Fax:732-571-0651
Practice Address - Street 1:54 BROAD ST
Practice Address - Street 2:SUITE L-101
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1943
Practice Address - Country:US
Practice Address - Phone:732-747-6311
Practice Address - Fax:732-571-0651
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ37PC00232100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional