Individual
JESSENIA M CANTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
121 CHANLON RD, NEW PROVIDENCE, NJ 07974-1543
(973) 299-9954
Mailing address
121 CHANLON RD, NEW PROVIDENCE, NJ 07974-1543
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05758600
NJ
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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