Individual
JODY RISCEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
1063 MOSSER RD APT S205, BREINIGSVILLE, PA 18031-1395
(570) 236-4581
Mailing address
1063 MOSSER RD APT S205, BREINIGSVILLE, PA 18031-1395
(570) 236-4581
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00113500
NJ
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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