Provider Demographics
NPI:1467209635
Name:LONDONO, MARY L
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:L
Last Name:LONDONO
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 1:817 MCCANDLESS PL
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-1345
Mailing Address - Country:US
Mailing Address - Phone:908-764-0181
Mailing Address - Fax:
Practice Address - Street 1:817 MCCANDLESS PL
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-1345
Practice Address - Country:US
Practice Address - Phone:908-764-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker