Individual
JACQUONA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
532 MCKINLEY ST, PASSAIC, NJ 07055-2218
(862) 383-6823
Mailing address
532 MCKINLEY ST, PASSAIC, NJ 07055-2218
(862) 383-6823
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL07433600
NJ
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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