Organization
JENNIFER IACOVONE, LPC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER IACOVONE L.P.C. (PROFESSIONAL COUNSELOR)
(856) 214-2811
Entity
Organization
Contact information
Practice address
68 PAULSBORO RD, WOOLWICH TOWNSHIP, NJ 08085-1364
(856) 214-2811
Mailing address
21 S JACKSON ST, WOODBURY, NJ 08096-5907
(856) 214-2811
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
37PC00516500
NJ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
37PC00516500
NJ
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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