Individual
JESSICA EBEGBULEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
183 S ORANGE AVE, NEWARK, NJ 07103-2757
(732) 235-5000
Mailing address
183 S ORANGE AVE, NEWARK, NJ 07103-2757
(732) 235-5000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC00103900
NJ
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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