Individual
JESSAMYN BLAKESLEE TABAKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
124 SETON PL, SOUTH ORANGE, NJ 07079-2514
(091) 761-2899
Mailing address
124 SETON PL, SOUTH ORANGE, NJ 07079-2514
(917) 612-8992
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC06149900
NJ
Other
Enumeration date
10/29/2024
Last updated
10/29/2024
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