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Individual
JACQUELYN CANTOR
Active
Individual
JACQUELYN CANTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,CSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
44SW01073100
NJ
163WP0808X
Psychiatric/Mental Health Registered Nurse
269645-1
NY
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
26NR08486500
NJ
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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