Individual
JENNIFER LYNN KOEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
73 WOOD RIDGE ST, WOOD RIDGE, NJ 07075-2416
(201) 704-5415
Mailing address
73 WOOD RIDGE ST, WOOD RIDGE, NJ 07075-2416
(201) 704-5415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04569100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44SC04569100
LCSW
NJ
Enumeration date
01/25/2018
Last updated
06/16/2018
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