Individual
MRS. JACQUELINE PERSICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDS, LAC
Contact information
Practice address
1 W CLIFF ST FL 1, SOMERVILLE, NJ 08876-1901
(908) 399-9024
Mailing address
14 PRESCOTT CT, BASKING RIDGE, NJ 07920-2983
(973) 641-5967
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00467800
NJ
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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