Individual
JENNIFER ILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
82 WESCOTT RD, BEDMINSTER, NJ 07921-2003
(732) 407-9783
Mailing address
82 WESCOTT RD, BEDMINSTER, NJ 07921-2003
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC01035500
NJ
Other
Enumeration date
04/19/2025
Last updated
05/09/2025
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