Individual
JESSICA MANGELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 MAIN RD STE 6, MONTVILLE, NJ 07045-9777
(973) 794-6888
Mailing address
112 MAIN RD STE 6, MONTVILLE, NJ 07045-9777
(973) 794-6888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00241900
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05568500
NJ
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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