Provider Demographics
NPI:1003782822
Name:WANOUNOU, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:WANOUNOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 COOK ST
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1875
Mailing Address - Country:US
Mailing Address - Phone:973-951-9723
Mailing Address - Fax:973-774-2275
Practice Address - Street 1:841 MOUNTAIN AVE STE 100
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3463
Practice Address - Country:US
Practice Address - Phone:973-774-2273
Practice Address - Fax:973-774-2275
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor