Individual
JENNA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC LPC LPAT ATR-BC
Contact information
Practice address
27 FORESTDALE RD, KINNELON, NJ 07405-2558
(973) 303-8613
Mailing address
1021 LAKESIDE DR E, HIGHLAND LAKES, NJ 07422-2049
(973) 303-8613
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37PC00871800
NJ
Other
Enumeration date
08/18/2022
Last updated
06/23/2024
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