Individual
JESSICA M CREIGHTON BODRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 CHESTNUT ST, RIDGEWOOD, NJ 07450-2504
(973) 897-6934
Mailing address
120 CHESTNUT ST, RIDGEWOOD, NJ 07450-2504
(973) 897-6934
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00842000
NJ
Other
Enumeration date
07/16/2025
Last updated
07/16/2025
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