Provider Demographics
NPI:1902505381
Name:SHABO, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SHABO
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 1:470 N FRANKLIN TPKE STE 201
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1385
Mailing Address - Country:US
Mailing Address - Phone:201-661-8070
Mailing Address - Fax:
Practice Address - Street 1:470 N FRANKLIN TPKE STE 201
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1385
Practice Address - Country:US
Practice Address - Phone:201-661-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health