Individual
JACQUELINE TASSIELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 VALLEY RD, MONTCLAIR, NJ 07042-2200
(201) 870-3201
Mailing address
100 VALLEY RD, MONTCLAIR, NJ 07042-2200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001916
NY
Other
Enumeration date
08/14/2017
Last updated
01/25/2023
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