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Individual
PAMELLA ZACKERU
Active
Individual
PAMELLA ZACKERU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09926641
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023701
AGENCY MEDICAID
NJ
Enumeration date
09/14/2016
Last updated
07/08/2020
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