Individual
YAJAIRA A VASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7101 KENNEDY BLVD, NORTH BERGEN, NJ 07047-3934
(201) 854-0500
Mailing address
7101 KENNEDY BLVD, NORTH BERGEN, NJ 07047-3934
(201) 854-0500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC05521900
NJ
251S00000X
Community/Behavioral Health Agency
Primary
44SC05521900
NJ
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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