Individual
JACLYN NICOLE BOUGADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17 WATCHUNG PLZ, MONTCLAIR, NJ 07042-4117
(973) 744-0804
Mailing address
60 BRANFORD RD, WHIPPANY, NJ 07981-1324
(973) 908-4750
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TL-4574
NJ
Other
Enumeration date
09/02/2024
Last updated
09/02/2024
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