Individual
JANE ALISON PENOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
395 S CENTER ST, ORANGE, NJ 07050-3205
(973) 675-3817
Mailing address
54 FAYSON LAKE RD, KINNELON, NJ 07405-3124
(973) 800-5663
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00369100
NJ
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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