Individual
MRS. JESSICA EVE BALLESTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
17-07 ROMAINE ST, FAIR LAWN, NJ 07410-2150
(201) 797-2660
Mailing address
186 LEXINGTON AVE, WESTWOOD, NJ 07675-2320
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04807400
NJ
Other
Enumeration date
12/01/2006
Last updated
07/08/2007
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