Individual
CANDICE CLAIRE EBBESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, EDS MFT
Contact information
Practice address
104 WAYNE ST, JERSEY CITY, NJ 07302-5573
(201) 780-0905
(973) 673-5782
Mailing address
395 S CENTER ST, ORANGE, NJ 07050-3205
(201) 780-0905
(973) 673-5782
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37F100175300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216352
—
NJ
Enumeration date
05/03/2013
Last updated
10/07/2014
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