Individual
JAZMIN WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
15 WEST PROSPECT STREET, EAST BRUNSWICK, NJ 08816
(732) 254-0600
Mailing address
15 WEST PROSPECT STREET, EAST BRUNSWICK, NJ 08816
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05972200
NJ
Other
Enumeration date
08/21/2014
Last updated
01/30/2017
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