Individual
JENNA YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 POWERVILLE RD, BOONTON, NJ 07005-8705
(973) 316-1869
Mailing address
130 POWERVILLE RD, BOONTON, NJ 07005-8705
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06631800
NJ
Other
Enumeration date
12/14/2021
Last updated
12/14/2021
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