Provider Demographics
NPI:1669250270
Name:ZAREMBA, STACEY LEE (PHD)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:LEE
Last Name:ZAREMBA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BEECHMONT TER
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-9722
Mailing Address - Country:US
Mailing Address - Phone:973-222-4295
Mailing Address - Fax:
Practice Address - Street 1:2 BEECHMONT TER
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-9722
Practice Address - Country:US
Practice Address - Phone:973-222-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00724300103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling