Individual
JESSICA A JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 PARAGON WAY STE 800, FREEHOLD, NJ 07728-9573
(732) 393-8391
(732) 308-4500
Mailing address
396 MADISON GDNS, OLD BRIDGE, NJ 08857-2826
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW-GTL-20-01766
NJ
1041C0700X
Clinical Social Worker
SW-GTL-20-01766
NJ
Other
Enumeration date
10/13/2022
Last updated
11/17/2022
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