Individual
KELLY JACLYN BICKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
35 BEAVERSON BLVD STE 8A, BRICK, NJ 08723-7861
(908) 373-1059
Mailing address
81 LORRAINE PL, BRICK, NJ 08724-3758
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00751600
NJ
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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