Individual
DR. JESSE WHITEHEAD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
15 CANTERBURY LN, TINTON FALLS, NJ 07724-2804
(732) 542-5925
(732) 542-5841
Mailing address
15 CANTERBURY LN, TINTON FALLS, NJ 07724-2804
(732) 542-5925
(732) 542-5841
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35SI00208700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3475107
—
NJ
Enumeration date
01/16/2007
Last updated
07/09/2007
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