Individual
JESSICA VLOSSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
591 LAKEHURST RD, TOMS RIVER, NJ 08755-8045
(732) 281-7440
(732) 349-5145
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
(732) 458-1700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00495900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
10/08/2019
Last updated
10/08/2019
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