Individual
MS. JESSICA DISLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2641 KENNEDY BLVD, JERSEY CITY, NJ 07306-5943
(201) 761-6417
Mailing address
275 GRAND AVE APT 16A, ENGLEWOOD, NJ 07631-4389
(201) 408-4071
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
02/24/2011
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