Individual
CHRISTIE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 RICHARD CT, POMONA, NY 10970-2307
(845) 642-2566
Mailing address
165 RICHARD CT, POMONA, NY 10970-2307
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00455
NY
101YP2500X
Professional Counselor
37PC00598400
NJ
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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