Individual
LAUREN DIANE JACQUEMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 OLD MARLTON PIKE STE 101, MEDFORD, NJ 08055-8772
(856) 223-2222
Mailing address
33 GREENBROOK DR, COLUMBUS, NJ 08022-2319
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00253300
NJ
101YM0800X
Mental Health Counselor
37PC00758800
NJ
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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