Provider Demographics
NPI:1740356575
Name:KOTSEN, ANNA MARIE (MARRIAGE AND FAMILY)
Entity type:Individual
Prefix:MRS
First Name:ANNA MARIE
Middle Name:
Last Name:KOTSEN
Suffix:
Gender:F
Credentials:MARRIAGE AND FAMILY
Other - Prefix:MISS
Other - First Name:ANNA MARIE
Other - Middle Name:
Other - Last Name:CIRACI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1823 MILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050
Mailing Address - Country:US
Mailing Address - Phone:609-978-2860
Mailing Address - Fax:
Practice Address - Street 1:59 BEAVER BROOK RD
Practice Address - Street 2:SUITE 303D
Practice Address - City:LINCOLN PARK
Practice Address - State:NJ
Practice Address - Zip Code:07035
Practice Address - Country:US
Practice Address - Phone:609-978-2860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100144700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist