Individual
DR. JACQUELINE SHALL-MCCUMISKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY. D.
Contact information
Practice address
525 ROUTE 73 N STE 104, MARLTON, NJ 08053-3422
(646) 479-8068
Mailing address
1675 RICHMOND RD, STATEN ISLAND, NY 10304-2317
(646) 479-8068
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021797
NY
Other
Enumeration date
08/29/2016
Last updated
09/29/2022
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