Individual
INGRID JACKELIN NOLASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
648 CLARK AVE, RIDGEFIELD, NJ 07657-2719
(201) 895-3110
Mailing address
127 63RD ST APT 7, WEST NEW YORK, NJ 07093-3036
(201) 895-3110
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC06102400
NJ
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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