Individual
MS. JILL CHICIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATR-BC, LPAT
Contact information
Practice address
408 S WHITE HORSE PIKE, AUDUBON, NJ 08106-1311
(856) 693-5775
Mailing address
1 LUPTON AVE, WOODBURY, NJ 08096-5901
(856) 693-5775
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
221700000X
Art Therapist
16LP00008100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0996025
—
NJ
Enumeration date
03/03/2015
Last updated
07/17/2024
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