Individual
MELISSA GREEN-JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
317 GODWIN AVE, MIDLAND PARK, NJ 07432-1519
(201) 241-2422
Mailing address
159 VREELAND AVE, RUTHERFORD, NJ 07070-2229
(201) 615-0204
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00400000
NJ
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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