Individual
JESSICA RONAE GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
183 S ORANGE AVE, NEWARK, NJ 07103-2757
(973) 972-0457
Mailing address
671 HOES LN W, PISCATAWAY, NJ 08854-8021
(973) 972-0457
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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