Provider Demographics
NPI:1386382919
Name:DEAN, AUBREY
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:DEAN
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 1:870 E ROUTE 130 APT J1
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2875
Mailing Address - Country:US
Mailing Address - Phone:480-248-4578
Mailing Address - Fax:
Practice Address - Street 1:115 E 5TH ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NJ
Practice Address - Zip Code:08065-2622
Practice Address - Country:US
Practice Address - Phone:609-880-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00846000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health