Individual
JACQUELINE ANN FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, LCADC
Contact information
Practice address
1001 COUNTY ROAD 517, HACKETTSTOWN, NJ 07840-2730
(908) 303-3850
Mailing address
PO BOX 267, BLAIRSTOWN, NJ 07825-0267
(908) 303-3850
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00179200
NJ
101YP2500X
Professional Counselor
Primary
37PC00496100
NJ
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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