Basic Information
| Provider Information | |||||||||
| NPI: | 1295391902 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMILLE | ||||||||
| FirstName: | DAPHNE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3499 RTE 9 STE 2C | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077283277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308849012 | ||||||||
| FaxNumber: | 7326947622 | ||||||||
| Practice Location | |||||||||
| Address1: | 3499 RTE 9 STE 2C | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077283277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7329822888 | ||||||||
| FaxNumber: | 8478595885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2019 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 37PC00858800 | NJ | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.