Individual
KELLY MARIE JENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
139 SOUTH ST, SUITE 201, NEW PROVIDENCE, NJ 07974-1999
(908) 477-6393
Mailing address
139 SOUTH ST, SUITE 201, NEW PROVIDENCE, NJ 07974-1999
(908) 477-6393
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00486500
NJ
Other
Enumeration date
07/01/2008
Last updated
01/21/2014
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