Individual
JENISE LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1683 ROUTE 88 W, BRICK, NJ 08724-3072
(732) 840-5266
Mailing address
1683 ROUTE 88 W, BRICK, NJ 08724-3072
(732) 840-5266
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
35SI00623100
NJ
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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