Provider Demographics
NPI:1649685991
Name:ZAMBENO, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:ZAMBENO
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 1:1868 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2031
Mailing Address - Country:US
Mailing Address - Phone:856-424-4408
Mailing Address - Fax:856-424-9164
Practice Address - Street 1:1868 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2031
Practice Address - Country:US
Practice Address - Phone:856-424-4408
Practice Address - Fax:856-424-9164
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00187000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health