Individual
JACQUELYN MYRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 KINGS RD, SICKLERVILLE, NJ 08081-1309
(856) 343-9859
Mailing address
11 KINGS RD, SICKLERVILLE, NJ 08081-1309
(856) 343-9859
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
170300000X
Genetic Counselor (M.S.)
Primary
—
—
174400000X
Specialist
—
—
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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