Individual
DR. JESSICA J DACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
190 ROUTE 18 STE 203, EAST BRUNSWICK, NJ 08816-1407
(732) 994-3456
Mailing address
53 FAIRBANKS ST, HILLSIDE, NJ 07205-2843
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
223-049
NJ
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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