Individual
ILEOLA MIRIAM ALLEN-JAMISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109-119 BROAD ST #308, NEWARK, NJ 07104
(973) 841-3961
Mailing address
109-119 BROAD ST #308, NEWARK, NJ 07104
(973) 841-3961
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
22DP00585400
NJ
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
05/08/2024
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