Individual
TRACEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5460 RIVERSIDE STATION BLVD, SECAUCUS, NJ 07094-4454
(888) 717-2932
Mailing address
5460 RIVERSIDE STATION BLVD, SECAUCUS, NJ 07094-4454
(888) 717-2932
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/11/2026
Last updated
05/11/2026
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