Individual
JENNIFER KOELLN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
611 STATE RT 46 W STE 100, HASBROUCK HEIGHTS, NJ 07604-3120
(201) 478-4166
Mailing address
121 GENEVIEVE AVE, HAWTHORNE, NJ 07506-2321
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06472700
NJ
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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